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 $40.74 Median $63.10 Typical High $81.28 | Facility | None | $40.74 | $63.10 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $66.07 Typical High $125.89 | Professional | None | $40.74 | $66.07 | $125.89 |
Ambetter Setting Professional Modifier None Typical Low $33.11 Median $81.28 Typical High $138.04 | Professional | None | $33.11 | $81.28 | $138.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $380.19 Median $776.25 Typical High $3,630.78 | Facility | None | $380.19 | $776.25 | $3,630.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $38.90 Median $58.88 Typical High $100.00 | Professional | None | $38.90 | $58.88 | $100.00 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $66.07 Median $91.20 Typical High $154.88 | Professional | 50 · Both sides | $66.07 | $91.20 | $154.88 |
CareSource Setting Professional Modifier None Typical Low $61.66 Median $79.43 Typical High $97.72 | Professional | None | $61.66 | $79.43 | $97.72 |
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 $44.67 Median $79.43 Typical High $151.36 | Professional | None | $44.67 | $79.43 | $151.36 |
Kaiser Permanente Setting Professional Modifier None Typical Low $47.86 Median $93.33 Typical High $128.82 | Professional | None | $47.86 | $93.33 | $128.82 |
Oscar Health Setting Facility Modifier None Typical Low $1,288.25 Median $1,479.11 Typical High $2,398.83 | Facility | None | $1,288.25 | $1,479.11 | $2,398.83 |
Oscar Health Setting Professional Modifier None Typical Low $47.86 Median $87.10 Typical High $162.18 | Professional | None | $47.86 | $87.10 | $162.18 |
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 $40.74 Median $77.62 Typical High $173.78 | Professional | None | $40.74 | $77.62 | $173.78 |
4 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 $20.42 Median $30.90 Typical High $33.88 | Professional | 52 · Reduced service | $20.42 | $30.90 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $12.30 Typical High $13.80 | Professional | 53 · Discontinued | $8.13 | $12.30 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $9.33 Typical High $10.23 | Professional | 55 · Aftercare only | $6.03 | $9.33 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $6.17 Typical High $6.92 | Professional | 56 · Pre-op care only | $4.07 | $6.17 | $6.92 |
Where Georgia sits
The same service costs 4.0 times more in Alaska than in Kentucky. 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· 30th of 51
$67.61
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.