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 $281.84 Median $4,570.88 Typical High $8,912.51 | Facility | None | $281.84 | $4,570.88 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $870.96 Typical High $2,187.76 | Professional | None | $281.84 | $870.96 | $2,187.76 |
Ambetter Setting Professional Modifier None Typical Low $213.80 Median $245.47 Typical High $436.52 | Professional | None | $213.80 | $245.47 | $436.52 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | 50 · Both sides | $645.65 | $645.65 | $645.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $831.76 Median $1,288.25 Typical High $3,162.28 | Facility | None | $831.76 | $1,288.25 | $3,162.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $323.59 Median $741.31 Typical High $2,344.23 | Professional | None | $323.59 | $741.31 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $489.78 Median $1,174.90 Typical High $3,548.13 | Professional | 50 · Both sides | $489.78 | $1,174.90 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $851.14 Typical High $2,238.72 | Professional | None | $295.12 | $851.14 | $2,238.72 |
Kaiser Permanente Setting Professional Modifier None Typical Low $275.42 Median $954.99 Typical High $2,041.74 | Professional | None | $275.42 | $954.99 | $2,041.74 |
Oscar Health Setting Professional Modifier None Typical Low $269.15 Median $758.58 Typical High $1,659.59 | Professional | None | $269.15 | $758.58 | $1,659.59 |
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 $269.15 Median $891.25 Typical High $2,344.23 | Professional | None | $269.15 | $891.25 | $2,344.23 |
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 $138.04 Median $416.87 Typical High $512.86 | Professional | 52 · Reduced service | $138.04 | $416.87 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $165.96 Typical High $208.93 | Professional | 53 · Discontinued | $54.95 | $165.96 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $630.96 Typical High $776.25 | Professional | 54 · Surgery only | $208.93 | $630.96 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $125.89 Typical High $154.88 | Professional | 55 · Aftercare only | $41.69 | $125.89 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $83.18 Typical High $104.71 | Professional | 56 · Pre-op care only | $27.54 | $83.18 | $104.71 |
Where Georgia sits
The same service costs 4.3 times more in Wisconsin than in Hawaii. 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· 30th of 51
$776
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.