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 $239.88 Median $4,897.79 Typical High $8,912.51 | Facility | None | $239.88 | $4,897.79 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $1,071.52 Typical High $2,884.03 | Professional | None | $234.42 | $1,071.52 | $2,884.03 |
Ambetter Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
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 $275.42 Median $676.08 Typical High $2,238.72 | Professional | None | $275.42 | $676.08 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $707.95 Typical High $2,570.40 | Professional | None | $245.47 | $707.95 | $2,570.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $234.42 Median $1,258.93 Typical High $2,187.76 | Professional | None | $234.42 | $1,258.93 | $2,187.76 |
Oscar Health Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,905.46 | $1,905.46 | $1,905.46 |
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 $223.87 Median $954.99 Typical High $2,630.27 | Professional | None | $223.87 | $954.99 | $2,630.27 |
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 $114.82 Median $512.86 Typical High $645.65 | Professional | 52 · Reduced service | $114.82 | $512.86 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $208.93 Typical High $257.04 | Professional | 53 · Discontinued | $46.77 | $208.93 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $776.25 Typical High $954.99 | Professional | 54 · Surgery only | $173.78 | $776.25 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $154.88 Typical High $194.98 | Professional | 55 · Aftercare only | $34.67 | $154.88 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $102.33 Typical High $128.82 | Professional | 56 · Pre-op care only | $22.91 | $102.33 | $128.82 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $194.98 Median $204.17 Typical High $977.24 | Professional | 59 · Distinct service | $194.98 | $204.17 | $977.24 |
Where Georgia sits
The same service costs 4.1 times more in Washington 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· 39th of 51
$741
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.