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 $69.18 Median $5,370.32 Typical High $7,585.78 | Facility | None | $69.18 | $5,370.32 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $128.82 Typical High $331.13 | Professional | None | $69.18 | $128.82 | $331.13 |
Ambetter Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $223.87 | Professional | None | $199.53 | $199.53 | $223.87 |
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 $91.20 Median $158.49 Typical High $257.04 | Professional | None | $91.20 | $158.49 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $93.33 Typical High $269.15 | Facility | None | $69.18 | $93.33 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $144.54 Typical High $275.42 | Professional | None | $79.43 | $144.54 | $275.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $66.07 Median $141.25 Typical High $173.78 | Professional | None | $66.07 | $141.25 | $173.78 |
Oscar Health Setting Professional Modifier None Typical Low $100.00 Median $173.78 Typical High $194.98 | Professional | None | $100.00 | $173.78 | $194.98 |
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 $77.62 Median $147.91 Typical High $323.59 | Professional | None | $77.62 | $147.91 | $323.59 |
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 $34.67 Median $60.26 Typical High $70.79 | Professional | 52 · Reduced service | $34.67 | $60.26 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $23.99 Typical High $28.18 | Professional | 53 · Discontinued | $13.80 | $23.99 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $89.13 Typical High $104.71 | Professional | 54 · Surgery only | $51.29 | $89.13 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $17.78 Typical High $20.89 | Professional | 55 · Aftercare only | $10.23 | $17.78 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $11.75 Typical High $14.13 | Professional | 56 · Pre-op care only | $6.92 | $11.75 | $14.13 |
Where Georgia sits
The same service costs 3.3 times more in Alaska than in Maryland. 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· 11th of 51
$158
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.