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 $831.76 Median $5,011.87 Typical High $8,912.51 | Facility | None | $831.76 | $5,011.87 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $1,862.09 Typical High $3,090.30 | Professional | None | $354.81 | $1,862.09 | $3,090.30 |
Ambetter Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $1,096.48 | Professional | None | $588.84 | $588.84 | $1,096.48 |
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 $436.52 Median $1,071.52 Typical High $3,981.07 | Professional | None | $436.52 | $1,071.52 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $1,122.02 Typical High $4,570.88 | Professional | None | $380.19 | $1,122.02 | $4,570.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $380.19 Median $2,344.23 Typical High $3,311.31 | Professional | None | $380.19 | $2,344.23 | $3,311.31 |
Oscar Health Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $3,467.37 | Professional | None | $3,467.37 | $3,467.37 | $3,467.37 |
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 $346.74 Median $1,737.80 Typical High $4,786.30 | Professional | None | $346.74 | $1,737.80 | $4,786.30 |
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 $181.97 Median $870.96 Typical High $1,122.02 | Professional | 52 · Reduced service | $181.97 | $870.96 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $354.81 Typical High $446.68 | Professional | 53 · Discontinued | $72.44 | $354.81 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $1,318.26 Typical High $1,659.59 | Professional | 54 · Surgery only | $275.42 | $1,318.26 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $263.03 Typical High $331.13 | Professional | 55 · Aftercare only | $54.95 | $263.03 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $173.78 Typical High $223.87 | Professional | 56 · Pre-op care only | $36.31 | $173.78 | $223.87 |
Where Georgia sits
The same service costs 5.5 times more in Washington than in Kentucky. 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· 38th of 51
$1,148
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.