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 $64.57 Median $3,019.95 Typical High $7,413.10 | Facility | None | $64.57 | $3,019.95 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $162.18 Typical High $363.08 | Professional | None | $61.66 | $162.18 | $363.08 |
Ambetter Setting Professional Modifier None Typical Low $53.70 Median $229.09 Typical High $275.42 | Professional | None | $53.70 | $229.09 | $275.42 |
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 $81.28 Typical High $162.18 | Professional | None | $51.29 | $81.28 | $162.18 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $91.20 Median $128.82 Typical High $245.47 | Professional | 50 · Both sides | $91.20 | $128.82 | $245.47 |
CareSource Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $199.53 | Professional | None | $186.21 | $186.21 | $199.53 |
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 $61.66 Median $147.91 Typical High $346.74 | Professional | None | $61.66 | $147.91 | $346.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $56.23 Median $169.82 Typical High $218.78 | Professional | None | $56.23 | $169.82 | $218.78 |
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 $61.66 Median $134.90 Typical High $380.19 | Professional | None | $61.66 | $134.90 | $380.19 |
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 $30.90 Median $74.13 Typical High $89.13 | Professional | 52 · Reduced service | $30.90 | $74.13 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $30.90 Typical High $35.48 | Professional | 53 · Discontinued | $12.30 | $30.90 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $112.20 Typical High $134.90 | Professional | 54 · Surgery only | $45.71 | $112.20 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $23.44 Typical High $26.92 | Professional | 55 · Aftercare only | $9.12 | $23.44 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $14.79 Typical High $17.78 | Professional | 56 · Pre-op care only | $6.17 | $14.79 | $17.78 |
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· 45th of 51
$100
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.