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 $85.11 Median $3,548.13 Typical High $7,413.10 | Facility | None | $85.11 | $3,548.13 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $169.82 Typical High $363.08 | Professional | None | $85.11 | $169.82 | $363.08 |
Ambetter Setting Professional Modifier None Typical Low $79.43 Median $144.54 Typical High $331.13 | Professional | None | $79.43 | $144.54 | $331.13 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $120.23 Median $213.80 Typical High $501.19 | Professional | 50 · Both sides | $120.23 | $213.80 | $501.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $371.54 Median $776.25 Typical High $3,630.78 | Facility | None | $371.54 | $776.25 | $3,630.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $72.44 Median $120.23 Typical High $354.81 | Professional | None | $72.44 | $120.23 | $354.81 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $128.82 Median $181.97 Typical High $354.81 | Professional | 50 · Both sides | $128.82 | $181.97 | $354.81 |
CareSource Setting Professional Modifier None Typical Low $144.54 Median $190.55 Typical High $234.42 | Professional | None | $144.54 | $190.55 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $346.74 Typical High $4,265.80 | Facility | None | $50.12 | $346.74 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $186.21 Typical High $363.08 | Professional | None | $95.50 | $186.21 | $363.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $87.10 Median $194.98 Typical High $891.25 | Professional | None | $87.10 | $194.98 | $891.25 |
Oscar Health Setting Facility Modifier None Typical Low $407.38 Median $3,890.45 Typical High $5,248.07 | Facility | None | $407.38 | $3,890.45 | $5,248.07 |
Oscar Health Setting Professional Modifier None Typical Low $141.25 Median $288.40 Typical High $331.13 | Professional | None | $141.25 | $288.40 | $331.13 |
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 $87.10 Median $169.82 Typical High $398.11 | Professional | None | $87.10 | $169.82 | $398.11 |
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 $74.13 Typical High $89.13 | Professional | 52 · Reduced service | $42.66 | $74.13 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $29.51 Typical High $35.48 | Professional | 53 · Discontinued | $16.98 | $29.51 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $109.65 Typical High $131.83 | Professional | 54 · Surgery only | $64.57 | $109.65 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $22.39 Typical High $26.92 | Professional | 55 · Aftercare only | $12.88 | $22.39 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $14.79 Typical High $17.78 | Professional | 56 · Pre-op care only | $8.51 | $14.79 | $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· 42nd of 51
$141
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.