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 $56.23 Median $74.13 Typical High $77.62 | Facility | None | $56.23 | $74.13 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $77.62 Typical High $151.36 | Professional | None | $56.23 | $77.62 | $151.36 |
Ambetter Setting Professional Modifier None Typical Low $64.57 Median $83.18 Typical High $158.49 | Professional | None | $64.57 | $83.18 | $158.49 |
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 $51.29 Median $79.43 Typical High $141.25 | Professional | None | $51.29 | $79.43 | $141.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $100.00 Median $125.89 Typical High $223.87 | Professional | 50 · Both sides | $100.00 | $125.89 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $64.57 Typical High $186.21 | Facility | None | $51.29 | $64.57 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $109.65 Typical High $169.82 | Professional | None | $63.10 | $109.65 | $169.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $60.26 Median $91.20 Typical High $245.47 | Professional | None | $60.26 | $91.20 | $245.47 |
Oscar Health Setting Professional Modifier None Typical Low $74.13 Median $104.71 Typical High $158.49 | Professional | None | $74.13 | $104.71 | $158.49 |
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 $57.54 Median $104.71 Typical High $186.21 | Professional | None | $57.54 | $104.71 | $186.21 |
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 $27.54 Median $35.48 Typical High $40.74 | Professional | 52 · Reduced service | $27.54 | $35.48 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $14.13 Typical High $16.22 | Professional | 53 · Discontinued | $11.22 | $14.13 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $10.47 Typical High $12.02 | Professional | 55 · Aftercare only | $8.32 | $10.47 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $7.08 Typical High $8.13 | Professional | 56 · Pre-op care only | $5.62 | $7.08 | $8.13 |
Where Georgia sits
The same service costs 3.5 times more in Alaska than in Florida. 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· 22nd of 51
$93.33
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.