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 $53.70 Median $3,548.13 Typical High $7,585.78 | Facility | None | $53.70 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $281.84 Typical High $794.33 | Professional | None | $53.70 | $281.84 | $794.33 |
Ambetter Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
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 $61.66 Median $245.47 Typical High $660.69 | Professional | None | $61.66 | $245.47 | $660.69 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $91.20 Median $371.54 Typical High $1,000.00 | Professional | 50 · Both sides | $91.20 | $371.54 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $173.78 Typical High $645.65 | Professional | None | $56.23 | $173.78 | $645.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $51.29 Median $288.40 Typical High $501.19 | Professional | None | $51.29 | $288.40 | $501.19 |
Oscar Health Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,778.28 Typical High $2,818.38 | Facility | None | $691.83 | $1,778.28 | $2,818.38 |
United Setting Professional Modifier None Typical Low $50.12 Median $281.84 Typical High $707.95 | Professional | None | $50.12 | $281.84 | $707.95 |
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 $26.30 Median $128.82 Typical High $169.82 | Professional | 52 · Reduced service | $26.30 | $128.82 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $51.29 Typical High $67.61 | Professional | 53 · Discontinued | $10.47 | $51.29 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $194.98 Typical High $251.19 | Professional | 54 · Surgery only | $39.81 | $194.98 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $38.90 Typical High $50.12 | Professional | 55 · Aftercare only | $7.94 | $38.90 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $25.70 Typical High $33.88 | Professional | 56 · Pre-op care only | $5.25 | $25.70 | $33.88 |
Where Georgia sits
The same service costs 4.9 times more in Iowa 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· 26th of 51
$263
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.