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 $316.23 Median $3,548.13 Typical High $7,585.78 | Facility | None | $316.23 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $234.42 Typical High $380.19 | Professional | None | $85.11 | $234.42 | $380.19 |
Ambetter Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
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 $79.43 Median $144.54 Typical High $295.12 | Professional | None | $79.43 | $144.54 | $295.12 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $147.91 Median $213.80 Typical High $457.09 | Professional | 50 · Both sides | $147.91 | $213.80 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $257.04 Typical High $676.08 | Professional | None | $95.50 | $257.04 | $676.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $85.11 Median $389.05 Typical High $660.69 | Professional | None | $85.11 | $389.05 | $660.69 |
Oscar Health Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
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 $87.10 Median $275.42 Typical High $741.31 | Professional | None | $87.10 | $275.42 | $741.31 |
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 $42.66 Median $123.03 Typical High $169.82 | Professional | 52 · Reduced service | $42.66 | $123.03 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $48.98 Typical High $67.61 | Professional | 53 · Discontinued | $16.98 | $48.98 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $204.17 Typical High $257.04 | Professional | 54 · Surgery only | $63.10 | $204.17 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $37.15 Typical High $51.29 | Professional | 55 · Aftercare only | $12.59 | $37.15 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $24.55 Typical High $33.88 | Professional | 56 · Pre-op care only | $8.51 | $24.55 | $33.88 |
Where Georgia sits
The same service costs 4.2 times more in Washington 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· 45th of 51
$155
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.