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 $169.82 Median $3,548.13 Typical High $7,585.78 | Facility | None | $169.82 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $1,862.09 Typical High $3,630.78 | Professional | None | $169.82 | $1,862.09 | $3,630.78 |
Ambetter Setting Professional Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $3,715.35 | Professional | None | $3,715.35 | $3,715.35 | $3,715.35 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,943.28 Median $11,220.18 Typical High $23,442.29 | Facility | None | $7,943.28 | $11,220.18 | $23,442.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $194.98 Median $1,513.56 Typical High $4,168.69 | Professional | None | $194.98 | $1,513.56 | $4,168.69 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $30.90 Median $218.78 Typical High $676.08 | Professional | 80 · Assistant surgeon | $30.90 | $218.78 | $676.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $26.92 Median $190.55 Typical High $588.84 | Professional | AS · PA/NP assist | $26.92 | $190.55 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $741.31 Typical High $3,235.94 | Facility | None | $501.19 | $741.31 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $1,513.56 Typical High $4,466.84 | Professional | None | $177.83 | $1,513.56 | $4,466.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $162.18 Median $1,862.09 Typical High $4,365.16 | Professional | None | $162.18 | $1,862.09 | $4,365.16 |
Oscar Health Setting Professional Modifier None Typical Low $245.47 Median $2,630.27 Typical High $3,162.28 | Professional | None | $245.47 | $2,630.27 | $3,162.28 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $3,715.35 Typical High $9,549.93 | Facility | None | $1,513.56 | $3,715.35 | $9,549.93 |
United Setting Professional Modifier None Typical Low $177.83 Median $1,513.56 Typical High $4,786.30 | Professional | None | $177.83 | $1,513.56 | $4,786.30 |
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 $117.49 Typical High $1,122.02 | Professional | 52 · Reduced service | $85.11 | $117.49 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $47.86 Typical High $446.68 | Professional | 53 · Discontinued | $33.88 | $47.86 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $177.83 Typical High $1,659.59 | Professional | 54 · Surgery only | $125.89 | $177.83 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $35.48 Typical High $331.13 | Professional | 55 · Aftercare only | $25.70 | $35.48 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $23.44 Typical High $223.87 | Professional | 56 · Pre-op care only | $16.98 | $23.44 | $223.87 |
Where Georgia sits
The same service costs 11.2 times more in Oklahoma 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· 27th of 51
$1,778
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.