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 $123.03 Median $5,011.87 Typical High $10,000.00 | Facility | None | $123.03 | $5,011.87 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $123.03 Typical High $165.96 | Professional | None | $114.82 | $123.03 | $165.96 |
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 $85.11 Median $147.91 Typical High $251.19 | Professional | None | $85.11 | $147.91 | $251.19 |
CareSource Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | None | $97.72 | $97.72 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $323.59 Typical High $1,513.56 | Facility | None | $245.47 | $323.59 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $186.21 Typical High $323.59 | Professional | None | $117.49 | $186.21 | $323.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $97.72 Median $125.89 Typical High $616.60 | Professional | None | $97.72 | $125.89 | $616.60 |
Oscar Health Setting Professional Modifier None Typical Low $165.96 Median $173.78 Typical High $208.93 | Professional | None | $165.96 | $173.78 | $208.93 |
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 $95.50 Median $162.18 Typical High $354.81 | Professional | None | $95.50 | $162.18 | $354.81 |
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 $56.23 Median $61.66 Typical High $74.13 | Professional | 52 · Reduced service | $56.23 | $61.66 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $24.55 Typical High $29.51 | Professional | 53 · Discontinued | $22.39 | $24.55 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $91.20 Typical High $109.65 | Professional | 54 · Surgery only | $85.11 | $91.20 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $18.20 Typical High $21.88 | Professional | 55 · Aftercare only | $16.98 | $18.20 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $12.30 Typical High $14.79 | Professional | 56 · Pre-op care only | $11.22 | $12.30 | $14.79 |
Where Georgia sits
The same service costs 4.8 times more in Alaska 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· 20th of 51
$155
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.