How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $46.77 Median $2,754.23 Typical High $7,413.10 | Facility | None | $46.77 | $2,754.23 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $66.07 Typical High $125.89 | Professional | None | $46.77 | $66.07 | $125.89 |
Ambetter Setting Professional Modifier None Typical Low $39.81 Median $72.44 Typical High $125.89 | Professional | None | $39.81 | $72.44 | $125.89 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $77.62 Median $109.65 Typical High $199.53 | Professional | 50 · Both sides | $77.62 | $109.65 | $199.53 |
Anthem BCBS Setting Facility Modifier None Typical Low $380.19 Median $776.25 Typical High $3,630.78 | Facility | None | $380.19 | $776.25 | $3,630.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $53.70 Median $81.28 Typical High $134.90 | Professional | None | $53.70 | $81.28 | $134.90 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $89.13 Median $128.82 Typical High $208.93 | Professional | 50 · Both sides | $89.13 | $128.82 | $208.93 |
CareSource Setting Professional Modifier None Typical Low $58.88 Median $75.86 Typical High $93.33 | Professional | None | $58.88 | $75.86 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $38.90 Median $51.29 Typical High $602.56 | Facility | None | $38.90 | $51.29 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $89.13 Typical High $147.91 | Professional | None | $52.48 | $89.13 | $147.91 |
Kaiser Permanente Setting Professional Modifier None Typical Low $46.77 Median $81.28 Typical High $128.82 | Professional | None | $46.77 | $81.28 | $128.82 |
Oscar Health Setting Facility Modifier None Typical Low $575.44 Median $1,023.29 Typical High $1,737.80 | Facility | None | $575.44 | $1,023.29 | $1,737.80 |
Oscar Health Setting Professional Modifier None Typical Low $64.57 Median $81.28 Typical High $134.90 | Professional | None | $64.57 | $81.28 | $134.90 |
United Setting Facility Modifier None Typical Low $79.43 Median $158.49 Typical High $1,778.28 | Facility | None | $79.43 | $158.49 | $1,778.28 |
United Setting Professional Modifier None Typical Low $47.86 Median $83.18 Typical High $158.49 | Professional | None | $47.86 | $83.18 | $158.49 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $23.44 Median $29.51 Typical High $34.67 | Professional | 52 · Reduced service | $23.44 | $29.51 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $11.75 Typical High $13.80 | Professional | 53 · Discontinued | $9.33 | $11.75 | $13.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $34.67 Median $43.65 Typical High $52.48 | Professional | 54 · Surgery only | $34.67 | $43.65 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $8.91 Typical High $10.47 | Professional | 55 · Aftercare only | $7.08 | $8.91 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $5.89 Typical High $6.92 | Professional | 56 · Pre-op care only | $4.68 | $5.89 | $6.92 |
Where Georgia sits
The same service costs 4.2 times more in Alaska than in Florida. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Georgia· 17th of 51
$81.28
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.