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 $141.25 Median $3,630.78 Typical High $7,943.28 | Facility | None | $141.25 | $3,630.78 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $141.25 Typical High $186.21 | Professional | None | $134.90 | $141.25 | $186.21 |
Anthem BCBS Setting Facility Modifier None Typical Low $380.19 Median $776.25 Typical High $3,630.78 | Facility | None | $380.19 | $776.25 | $3,630.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $131.83 Median $181.97 Typical High $295.12 | Professional | None | $131.83 | $181.97 | $295.12 |
CareSource Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $323.59 Typical High $660.69 | Facility | None | $245.47 | $323.59 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $223.87 Typical High $371.54 | Professional | None | $147.91 | $223.87 | $371.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $131.83 Median $165.96 Typical High $426.58 | Professional | None | $131.83 | $165.96 | $426.58 |
Oscar Health Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
United Setting Facility Modifier None Typical Low $79.43 Median $158.49 Typical High $1,778.28 | Facility | None | $79.43 | $158.49 | $1,778.28 |
United Setting Professional Modifier None Typical Low $120.23 Median $204.17 Typical High $426.58 | Professional | None | $120.23 | $204.17 | $426.58 |
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 $67.61 Median $70.79 Typical High $85.11 | Professional | 52 · Reduced service | $67.61 | $70.79 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $28.18 Typical High $33.88 | Professional | 53 · Discontinued | $26.92 | $28.18 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $107.15 Typical High $128.82 | Professional | 54 · Surgery only | $102.33 | $107.15 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $21.38 Typical High $25.70 | Professional | 55 · Aftercare only | $20.42 | $21.38 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $14.13 Typical High $16.98 | Professional | 56 · Pre-op care only | $13.49 | $14.13 | $16.98 |
Where Georgia sits
The same service costs 5.1 times more in Alaska than in Utah. 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· 18th of 51
$186
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.