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 $54.95 Median $4,897.79 Typical High $8,912.51 | Facility | None | $54.95 | $4,897.79 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $138.04 Typical High $371.54 | Professional | None | $54.95 | $138.04 | $371.54 |
Ambetter Setting Professional Modifier None Typical Low $44.67 Median $81.28 Typical High $251.19 | Professional | None | $44.67 | $81.28 | $251.19 |
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 $61.66 Median $123.03 Typical High $316.23 | Professional | None | $61.66 | $123.03 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $151.36 Typical High $316.23 | Professional | None | $56.23 | $151.36 | $316.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $51.29 Median $138.04 Typical High $354.81 | Professional | None | $51.29 | $138.04 | $354.81 |
Oscar Health Setting Professional Modifier None Typical Low $46.77 Median $107.15 Typical High $234.42 | Professional | None | $46.77 | $107.15 | $234.42 |
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 $51.29 Median $141.25 Typical High $346.74 | Professional | None | $51.29 | $141.25 | $346.74 |
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 $26.92 Median $61.66 Typical High $77.62 | Professional | 52 · Reduced service | $26.92 | $61.66 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $24.55 Typical High $30.90 | Professional | 53 · Discontinued | $10.72 | $24.55 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $91.20 Typical High $114.82 | Professional | 54 · Surgery only | $39.81 | $91.20 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $18.20 Typical High $22.91 | Professional | 55 · Aftercare only | $8.13 | $18.20 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $12.30 Typical High $15.49 | Professional | 56 · Pre-op care only | $5.37 | $12.30 | $15.49 |
Where Georgia sits
The same service costs 2.8 times more in Wisconsin than in Florida. 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· 17th of 51
$138
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.