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 $69.18 Median $3,548.13 Typical High $7,585.78 | Facility | None | $69.18 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $190.55 Typical High $489.78 | Professional | None | $69.18 | $190.55 | $489.78 |
Ambetter Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | None | $380.19 | $380.19 | $380.19 |
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 $64.57 Median $117.49 Typical High $218.78 | Professional | None | $64.57 | $117.49 | $218.78 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $117.49 Median $177.83 Typical High $363.08 | Professional | 50 · Both sides | $117.49 | $177.83 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $186.21 Typical High $467.74 | Professional | None | $77.62 | $186.21 | $467.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $69.18 Median $223.87 Typical High $630.96 | Professional | None | $69.18 | $223.87 | $630.96 |
Oscar Health Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $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 $70.79 Median $186.21 Typical High $457.09 | Professional | None | $70.79 | $186.21 | $457.09 |
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 $34.67 Median $85.11 Typical High $102.33 | Professional | 52 · Reduced service | $34.67 | $85.11 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $33.88 Typical High $41.69 | Professional | 53 · Discontinued | $13.80 | $33.88 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $128.82 Typical High $154.88 | Professional | 54 · Surgery only | $51.29 | $128.82 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $25.70 Typical High $30.90 | Professional | 55 · Aftercare only | $10.23 | $25.70 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $16.98 Typical High $20.89 | Professional | 56 · Pre-op care only | $6.92 | $16.98 | $20.89 |
Where Georgia sits
The same service costs 3.5 times more in North Carolina than in Indiana. 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· 42nd of 51
$135
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.