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 $120.23 Median $3,630.78 Typical High $7,585.78 | Facility | None | $120.23 | $3,630.78 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $316.23 | Professional | None | $120.23 | $120.23 | $316.23 |
Ambetter Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,511.89 Median $7,943.28 Typical High $7,943.28 | Facility | None | $2,511.89 | $7,943.28 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $131.83 Median $181.97 Typical High $275.42 | Professional | None | $131.83 | $181.97 | $275.42 |
CareSource Setting Professional Modifier None Typical Low $107.15 Median $138.04 Typical High $169.82 | Professional | None | $107.15 | $138.04 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $741.31 Typical High $7,079.46 | Facility | None | $501.19 | $741.31 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $190.55 Typical High $309.03 | Professional | None | $138.04 | $190.55 | $309.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $204.17 Median $338.84 Typical High $338.84 | Professional | None | $204.17 | $338.84 | $338.84 |
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 $104.71 Median $177.83 Typical High $309.03 | Professional | None | $104.71 | $177.83 | $309.03 |
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 $60.26 Median $60.26 Typical High $67.61 | Professional | 52 · Reduced service | $60.26 | $60.26 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $23.99 Typical High $26.92 | Professional | 53 · Discontinued | $23.99 | $23.99 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $91.20 Typical High $100.00 | Professional | 54 · Surgery only | $89.13 | $91.20 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $18.20 Typical High $19.95 | Professional | 55 · Aftercare only | $17.78 | $18.20 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.02 Typical High $13.49 | Professional | 56 · Pre-op care only | $12.02 | $12.02 | $13.49 |
Where Georgia sits
The same service costs 4.0 times more in Alaska than in Delaware. 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· 20th of 51
$178
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.