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 $16.22 Median $16.22 Typical High $87.10 | Facility | None | $16.22 | $16.22 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $16.22 Median $58.88 Typical High $89.13 | Professional | None | $16.22 | $58.88 | $89.13 |
Ambetter Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
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 $13.18 Median $24.55 Typical High $50.12 | Professional | None | $13.18 | $24.55 | $50.12 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $23.99 Median $35.48 Typical High $57.54 | Professional | 50 · Both sides | $23.99 | $35.48 | $57.54 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $83.18 Typical High $630.96 | Facility | None | $63.10 | $83.18 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $18.62 Median $42.66 Typical High $158.49 | Professional | None | $18.62 | $42.66 | $158.49 |
Kaiser Permanente Setting Professional Modifier None Typical Low $15.49 Median $83.18 Typical High $380.19 | Professional | None | $15.49 | $83.18 | $380.19 |
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 $16.98 Median $69.18 Typical High $169.82 | Professional | None | $16.98 | $69.18 | $169.82 |
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 $8.13 Median $29.51 Typical High $43.65 | Professional | 52 · Reduced service | $8.13 | $29.51 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.24 Median $11.75 Typical High $17.78 | Professional | 53 · Discontinued | $3.24 | $11.75 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.45 Median $8.71 Typical High $13.18 | Professional | 55 · Aftercare only | $2.45 | $8.71 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.62 Median $6.31 Typical High $8.71 | Professional | 56 · Pre-op care only | $1.62 | $6.31 | $8.71 |
Where Georgia sits
The same service costs 5.9 times more in Iowa 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· 47th of 51
$28.18
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.