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 $630.96 Median $3,548.13 Typical High $7,585.78 | Facility | None | $630.96 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $562.34 Typical High $1,584.89 | Professional | None | $186.21 | $562.34 | $1,584.89 |
Ambetter Setting Professional Modifier None Typical Low $151.36 Median $281.84 Typical High $1,348.96 | Professional | None | $151.36 | $281.84 | $1,348.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $501.19 Median $1,000.00 Typical High $4,570.88 | Facility | None | $501.19 | $1,000.00 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $213.80 Median $537.03 Typical High $1,122.02 | Professional | None | $213.80 | $537.03 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $676.08 Typical High $1,122.02 | Facility | None | $512.86 | $676.08 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $562.34 Typical High $1,737.80 | Professional | None | $194.98 | $562.34 | $1,737.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $181.97 Median $812.83 Typical High $3,890.45 | Professional | None | $181.97 | $812.83 | $3,890.45 |
Oscar Health Setting Professional Modifier None Typical Low $169.82 Median $645.65 Typical High $1,412.54 | Professional | None | $169.82 | $645.65 | $1,412.54 |
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 $616.60 Typical High $1,737.80 | Professional | None | $177.83 | $616.60 | $1,737.80 |
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 $91.20 Median $239.88 Typical High $426.58 | Professional | 52 · Reduced service | $91.20 | $239.88 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $95.50 Typical High $169.82 | Professional | 53 · Discontinued | $37.15 | $95.50 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $354.81 Typical High $630.96 | Professional | 54 · Surgery only | $138.04 | $354.81 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $70.79 Typical High $125.89 | Professional | 55 · Aftercare only | $27.54 | $70.79 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $47.86 Typical High $85.11 | Professional | 56 · Pre-op care only | $18.62 | $47.86 | $85.11 |
Where Georgia sits
The same service costs 5.2 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· 32nd of 51
$603
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.