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 $630.96 Median $3,548.13 Typical High $7,585.78 | Facility | None | $630.96 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $1,096.48 Typical High $1,548.82 | Professional | None | $263.03 | $1,096.48 | $1,548.82 |
Ambetter Setting Professional Modifier None Typical Low $346.74 Median $436.52 Typical High $446.68 | Professional | None | $346.74 | $436.52 | $446.68 |
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 $323.59 Median $1,023.29 Typical High $2,454.71 | Professional | None | $323.59 | $1,023.29 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $489.78 Median $1,621.81 Typical High $3,630.78 | Professional | 50 · Both sides | $489.78 | $1,621.81 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $1,148.15 Typical High $3,388.44 | Professional | None | $281.84 | $1,148.15 | $3,388.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $281.84 Median $1,819.70 Typical High $6,918.31 | Professional | None | $281.84 | $1,819.70 | $6,918.31 |
Oscar Health Setting Professional Modifier None Typical Low $288.40 Median $1,412.54 Typical High $3,162.28 | Professional | None | $288.40 | $1,412.54 | $3,162.28 |
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 $251.19 Median $1,258.93 Typical High $3,548.13 | Professional | None | $251.19 | $1,258.93 | $3,548.13 |
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 $131.83 Median $501.19 Typical High $776.25 | Professional | 52 · Reduced service | $131.83 | $501.19 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $199.53 Typical High $309.03 | Professional | 53 · Discontinued | $52.48 | $199.53 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $758.58 Typical High $1,148.15 | Professional | 54 · Surgery only | $199.53 | $758.58 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $151.36 Typical High $234.42 | Professional | 55 · Aftercare only | $39.81 | $151.36 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $100.00 Typical High $154.88 | Professional | 56 · Pre-op care only | $26.30 | $100.00 | $154.88 |
Where Georgia sits
The same service costs 6.5 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· 37th of 51
$1,023
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.