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 $77.62 Median $3,548.13 Typical High $7,585.78 | Facility | None | $77.62 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $77.62 Typical High $204.17 | Professional | None | $57.54 | $77.62 | $204.17 |
Ambetter Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | None | $69.18 | $69.18 | $69.18 |
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 $61.66 Median $104.71 Typical High $169.82 | Professional | None | $61.66 | $104.71 | $169.82 |
CareSource Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
Cigna Setting Facility Modifier None Typical Low $47.86 Median $64.57 Typical High $602.56 | Facility | None | $47.86 | $64.57 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $109.65 Typical High $158.49 | Professional | None | $63.10 | $109.65 | $158.49 |
Kaiser Permanente Setting Professional Modifier None Typical Low $63.10 Median $93.33 Typical High $112.20 | Professional | None | $63.10 | $93.33 | $112.20 |
Oscar Health Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
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 $58.88 Median $109.65 Typical High $204.17 | Professional | None | $58.88 | $109.65 | $204.17 |
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 $28.84 Median $38.90 Typical High $43.65 | Professional | 52 · Reduced service | $28.84 | $38.90 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $15.49 Typical High $17.38 | Professional | 53 · Discontinued | $11.48 | $15.49 | $17.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $57.54 Typical High $66.07 | Professional | 54 · Surgery only | $42.66 | $57.54 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $11.75 Typical High $13.18 | Professional | 55 · Aftercare only | $8.51 | $11.75 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $7.76 Typical High $8.71 | Professional | 56 · Pre-op care only | $5.75 | $7.76 | $8.71 |
Where Georgia sits
The same service costs 4.3 times more in Alaska than in New Jersey. 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· 14th of 51
$105
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.