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 $398.11 Median $5,370.32 Typical High $7,762.47 | Facility | None | $398.11 | $5,370.32 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $1,584.89 Typical High $4,786.30 | Professional | None | $398.11 | $1,584.89 | $4,786.30 |
Ambetter Setting Professional Modifier None Typical Low $302.00 Median $331.13 Typical High $2,187.76 | Professional | None | $302.00 | $331.13 | $2,187.76 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $380.19 Median $478.63 Typical High $489.78 | Professional | 50 · Both sides | $380.19 | $478.63 | $489.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,380.38 Median $4,365.16 Typical High $9,332.54 | Facility | None | $1,380.38 | $4,365.16 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $478.63 Median $1,513.56 Typical High $3,548.13 | Professional | None | $478.63 | $1,513.56 | $3,548.13 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $724.44 Median $2,454.71 Typical High $5,370.32 | Professional | 50 · Both sides | $724.44 | $2,454.71 | $5,370.32 |
CareSource Setting Professional Modifier None Typical Low $1,698.24 Median $1,905.46 Typical High $2,691.53 | Professional | None | $1,698.24 | $1,905.46 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $1,659.59 Typical High $5,128.61 | Professional | None | $416.87 | $1,659.59 | $5,128.61 |
Kaiser Permanente Setting Professional Modifier None Typical Low $416.87 Median $2,691.53 Typical High $10,964.78 | Professional | None | $416.87 | $2,691.53 | $10,964.78 |
Oscar Health Setting Professional Modifier None Typical Low $416.87 Median $2,089.30 Typical High $4,677.35 | Professional | None | $416.87 | $2,089.30 | $4,677.35 |
United Setting Facility Modifier None Typical Low $5,495.41 Median $9,549.93 Typical High $17,378.01 | Facility | None | $5,495.41 | $9,549.93 | $17,378.01 |
United Setting Professional Modifier None Typical Low $371.54 Median $1,819.70 Typical High $5,248.07 | Professional | None | $371.54 | $1,819.70 | $5,248.07 |
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 $199.53 Median $724.44 Typical High $1,174.90 | Professional | 52 · Reduced service | $199.53 | $724.44 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $295.12 Typical High $467.74 | Professional | 53 · Discontinued | $79.43 | $295.12 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $1,096.48 Typical High $1,778.28 | Professional | 54 · Surgery only | $295.12 | $1,096.48 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $218.78 Typical High $354.81 | Professional | 55 · Aftercare only | $58.88 | $218.78 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $147.91 Typical High $234.42 | Professional | 56 · Pre-op care only | $39.81 | $147.91 | $234.42 |
Where Georgia sits
The same service costs 6.2 times more in Washington than in Maryland. 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
$1,622
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.