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 $831.76 Median $5,011.87 Typical High $7,943.28 | Facility | None | $831.76 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $1,584.89 Typical High $3,235.94 | Professional | None | $173.78 | $1,584.89 | $3,235.94 |
Ambetter Setting Professional Modifier None Typical Low $1,202.26 Median $1,348.96 Typical High $2,630.27 | Professional | None | $1,202.26 | $1,348.96 | $2,630.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $512.86 Median $1,000.00 Typical High $4,570.88 | Facility | None | $512.86 | $1,000.00 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $181.97 Median $1,096.48 Typical High $3,090.30 | Professional | None | $181.97 | $1,096.48 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $263.03 Median $1,659.59 Typical High $4,466.84 | Professional | 50 · Both sides | $263.03 | $1,659.59 | $4,466.84 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,380.38 Typical High $2,570.40 | Facility | None | $602.56 | $1,380.38 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $1,819.70 Typical High $3,630.78 | Professional | None | $177.83 | $1,819.70 | $3,630.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $165.96 Median $1,513.56 Typical High $3,630.78 | Professional | None | $165.96 | $1,513.56 | $3,630.78 |
Oscar Health Setting Professional Modifier None Typical Low $158.49 Median $1,230.27 Typical High $2,754.23 | Professional | None | $158.49 | $1,230.27 | $2,754.23 |
United Setting Facility Modifier None Typical Low $501.19 Median $724.44 Typical High $3,548.13 | Facility | None | $501.19 | $724.44 | $3,548.13 |
United Setting Professional Modifier None Typical Low $177.83 Median $1,659.59 Typical High $3,981.07 | Professional | None | $177.83 | $1,659.59 | $3,981.07 |
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 $85.11 Median $120.23 Typical High $954.99 | Professional | 52 · Reduced service | $85.11 | $120.23 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $47.86 Typical High $389.05 | Professional | 53 · Discontinued | $34.67 | $47.86 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $177.83 Typical High $1,445.44 | Professional | 54 · Surgery only | $128.82 | $177.83 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $36.31 Typical High $288.40 | Professional | 55 · Aftercare only | $25.70 | $36.31 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $23.99 Typical High $190.55 | Professional | 56 · Pre-op care only | $17.38 | $23.99 | $190.55 |
Where Georgia sits
The same service costs 8.5 times more in Wisconsin than in Nebraska. 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· 42nd of 51
$1,096
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.