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 $263.03 Median $5,370.32 Typical High $7,943.28 | Facility | None | $263.03 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $263.03 Typical High $316.23 | Professional | None | $257.04 | $263.03 | $316.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $512.86 Median $1,000.00 Typical High $4,570.88 | Facility | None | $512.86 | $1,000.00 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $218.78 Median $346.74 Typical High $537.03 | Professional | None | $218.78 | $346.74 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $549.54 Typical High $2,398.83 | Facility | None | $457.09 | $549.54 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $436.52 Typical High $691.83 | Professional | None | $275.42 | $436.52 | $691.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $257.04 Median $281.84 Typical High $2,238.72 | Professional | None | $257.04 | $281.84 | $2,238.72 |
Oscar Health Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
United Setting Facility Modifier None Typical Low $371.54 Median $645.65 Typical High $3,981.07 | Facility | None | $371.54 | $645.65 | $3,981.07 |
United Setting Professional Modifier None Typical Low $245.47 Median $389.05 Typical High $794.33 | Professional | None | $245.47 | $389.05 | $794.33 |
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 $128.82 Median $131.83 Typical High $144.54 | Professional | 52 · Reduced service | $128.82 | $131.83 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $52.48 Typical High $57.54 | Professional | 53 · Discontinued | $51.29 | $52.48 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $39.81 Typical High $43.65 | Professional | 55 · Aftercare only | $38.90 | $39.81 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $26.30 Typical High $28.84 | Professional | 56 · Pre-op care only | $25.70 | $26.30 | $28.84 |
Ambetter Setting Professional Modifier 58 · Staged procedure Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | 58 · Staged procedure | $302.00 | $302.00 | $302.00 |
Where Georgia sits
The same service costs 4.1 times more in Wisconsin 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· 21st of 51
$417
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.