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 $269.15 Median $4,570.88 Typical High $7,585.78 | Facility | None | $269.15 | $4,570.88 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $275.42 Typical High $645.65 | Professional | None | $181.97 | $275.42 | $645.65 |
Ambetter Setting Professional Modifier None Typical Low $269.15 Median $436.52 Typical High $512.86 | Professional | None | $269.15 | $436.52 | $512.86 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $194.98 Median $707.95 Typical High $707.95 | Professional | 50 · Both sides | $194.98 | $707.95 | $707.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $851.14 Typical High $4,570.88 | Facility | None | $389.05 | $851.14 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $316.23 Typical High $512.86 | Professional | None | $204.17 | $316.23 | $512.86 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $331.13 Median $489.78 Typical High $776.25 | Professional | 50 · Both sides | $331.13 | $489.78 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $977.24 Typical High $1,288.25 | Facility | None | $398.11 | $977.24 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $323.59 Typical High $630.96 | Professional | None | $181.97 | $323.59 | $630.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $162.18 Median $288.40 Typical High $478.63 | Professional | None | $162.18 | $288.40 | $478.63 |
United Setting Facility Modifier None Typical Low $501.19 Median $724.44 Typical High $3,548.13 | Facility | None | $501.19 | $724.44 | $3,548.13 |
United Setting Professional Modifier None Typical Low $186.21 Median $338.84 Typical High $645.65 | Professional | None | $186.21 | $338.84 | $645.65 |
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 $91.20 Median $131.83 Typical High $151.36 | Professional | 52 · Reduced service | $91.20 | $131.83 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $52.48 Typical High $60.26 | Professional | 53 · Discontinued | $36.31 | $52.48 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $199.53 Typical High $223.87 | Professional | 54 · Surgery only | $134.90 | $199.53 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $39.81 Typical High $44.67 | Professional | 55 · Aftercare only | $26.92 | $39.81 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $26.30 Typical High $30.20 | Professional | 56 · Pre-op care only | $18.20 | $26.30 | $30.20 |
Where Georgia sits
The same service costs 3.1 times more in Alaska than in New York. 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· 27th of 51
$331
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.