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 $52.48 Median $3,548.13 Typical High $7,413.10 | Facility | None | $52.48 | $3,548.13 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $158.49 Typical High $380.19 | Professional | None | $51.29 | $158.49 | $380.19 |
Ambetter Setting Professional Modifier None Typical Low $42.66 Median $151.36 Typical High $302.00 | Professional | None | $42.66 | $151.36 | $302.00 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | 50 · Both sides | $457.09 | $457.09 | $457.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,943.28 Median $7,943.28 Typical High $7,943.28 | Facility | None | $7,943.28 | $7,943.28 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $48.98 Median $87.10 Typical High $181.97 | Professional | None | $48.98 | $87.10 | $181.97 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $93.33 Median $131.83 Typical High $281.84 | Professional | 50 · Both sides | $93.33 | $131.83 | $281.84 |
CareSource Setting Professional Modifier None Typical Low $138.04 Median $154.88 Typical High $218.78 | Professional | None | $138.04 | $154.88 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $158.49 Typical High $371.54 | Professional | None | $58.88 | $158.49 | $371.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $51.29 Median $186.21 Typical High $263.03 | Professional | None | $51.29 | $186.21 | $263.03 |
Oscar Health Setting Professional Modifier None Typical Low $46.77 Median $147.91 Typical High $323.59 | Professional | None | $46.77 | $147.91 | $323.59 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,778.28 Typical High $2,818.38 | Facility | None | $691.83 | $1,778.28 | $2,818.38 |
United Setting Professional Modifier None Typical Low $52.48 Median $154.88 Typical High $371.54 | Professional | None | $52.48 | $154.88 | $371.54 |
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 $25.70 Median $72.44 Typical High $89.13 | Professional | 52 · Reduced service | $25.70 | $72.44 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $28.84 Typical High $35.48 | Professional | 53 · Discontinued | $10.23 | $28.84 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $109.65 Typical High $134.90 | Professional | 54 · Surgery only | $38.02 | $109.65 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $21.88 Typical High $26.92 | Professional | 55 · Aftercare only | $7.59 | $21.88 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $14.45 Typical High $17.78 | Professional | 56 · Pre-op care only | $5.13 | $14.45 | $17.78 |
Where Georgia sits
The same service costs 3.9 times more in Alaska than in Virginia. 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· 47th of 51
$100
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.