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 $61.66 Median $3,548.13 Typical High $7,585.78 | Facility | None | $61.66 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $102.33 Typical High $204.17 | Professional | None | $61.66 | $102.33 | $204.17 |
Ambetter Setting Professional Modifier None Typical Low $53.70 Median $128.82 Typical High $204.17 | Professional | None | $53.70 | $128.82 | $204.17 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $144.54 Median $281.84 Typical High $302.00 | Professional | 50 · Both sides | $144.54 | $281.84 | $302.00 |
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 $77.62 Median $120.23 Typical High $181.97 | Professional | None | $77.62 | $120.23 | $181.97 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $114.82 Median $186.21 Typical High $275.42 | Professional | 50 · Both sides | $114.82 | $186.21 | $275.42 |
CareSource Setting Professional Modifier None Typical Low $89.13 Median $114.82 Typical High $141.25 | Professional | None | $89.13 | $114.82 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $83.18 Typical High $758.58 | Facility | None | $64.57 | $83.18 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $114.82 Typical High $223.87 | Professional | None | $69.18 | $114.82 | $223.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $58.88 Median $117.49 Typical High $524.81 | Professional | None | $58.88 | $117.49 | $524.81 |
Oscar Health Setting Professional Modifier None Typical Low $87.10 Median $112.20 Typical High $204.17 | Professional | None | $87.10 | $112.20 | $204.17 |
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 $63.10 Median $112.20 Typical High $234.42 | Professional | None | $63.10 | $112.20 | $234.42 |
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 $30.90 Median $42.66 Typical High $52.48 | Professional | 52 · Reduced service | $30.90 | $42.66 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $16.98 Typical High $20.89 | Professional | 53 · Discontinued | $12.30 | $16.98 | $20.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $63.10 Typical High $79.43 | Professional | 54 · Surgery only | $45.71 | $63.10 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $12.88 Typical High $15.85 | Professional | 55 · Aftercare only | $9.12 | $12.88 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $8.51 Typical High $10.47 | Professional | 56 · Pre-op care only | $6.17 | $8.51 | $10.47 |
Where Georgia sits
The same service costs 3.7 times more in Alaska than in Kentucky. 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· 16th of 51
$120
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.