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 $10.00 Median $30.90 Typical High $33.88 | Facility | None | $10.00 | $30.90 | $33.88 |
Aetna Setting Professional Modifier None Typical Low $10.00 Median $28.18 Typical High $46.77 | Professional | None | $10.00 | $28.18 | $46.77 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,943.28 Median $7,943.28 Typical High $7,943.28 | Facility | None | $7,943.28 | $7,943.28 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $11.75 Median $28.84 Typical High $54.95 | Professional | None | $11.75 | $28.84 | $54.95 |
CareSource Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $38.90 | Professional | None | $36.31 | $36.31 | $38.90 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $2,511.89 Typical High $4,265.80 | Facility | None | $512.86 | $2,511.89 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $10.72 Median $28.18 Typical High $75.86 | Professional | None | $10.72 | $28.18 | $75.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $9.77 Median $37.15 Typical High $64.57 | Professional | None | $9.77 | $37.15 | $64.57 |
Oscar Health Setting Facility Modifier None Typical Low $6,918.31 Median $6,918.31 Typical High $26,302.68 | Facility | None | $6,918.31 | $6,918.31 | $26,302.68 |
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 $10.47 Median $30.90 Typical High $77.62 | Professional | None | $10.47 | $30.90 | $77.62 |
6 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 $5.01 Median $14.13 Typical High $16.98 | Professional | 52 · Reduced service | $5.01 | $14.13 | $16.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.00 Median $5.75 Typical High $6.76 | Professional | 53 · Discontinued | $2.00 | $5.75 | $6.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $7.59 Median $21.38 Typical High $25.70 | Professional | 54 · Surgery only | $7.59 | $21.38 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.51 Median $4.27 Typical High $5.13 | Professional | 55 · Aftercare only | $1.51 | $4.27 | $5.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.00 Median $2.82 Typical High $3.39 | Professional | 56 · Pre-op care only | $1.00 | $2.82 | $3.39 |
Ambetter Setting Professional Modifier XU · Unusual separate service Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | XU · Unusual separate service | $67.61 | $67.61 | $67.61 |
Where Georgia sits
The same service costs 4.2 times more in Wisconsin than in Nebraska. 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· 25th of 51
$31.62
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.