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 $199.53 Median $3,548.13 Typical High $7,585.78 | Facility | None | $199.53 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $186.21 Typical High $223.87 | Professional | None | $81.28 | $186.21 | $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 $107.15 Median $186.21 Typical High $380.19 | Professional | None | $107.15 | $186.21 | $380.19 |
CareSource Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $190.55 Typical High $1,000.00 | Facility | None | $141.25 | $190.55 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $213.80 Typical High $436.52 | Professional | None | $95.50 | $213.80 | $436.52 |
Kaiser Permanente Setting Professional Modifier None Typical Low $81.28 Median $229.09 Typical High $794.33 | Professional | None | $81.28 | $229.09 | $794.33 |
Oscar Health Setting Professional Modifier None Typical Low $131.83 Median $302.00 Typical High $371.54 | Professional | None | $131.83 | $302.00 | $371.54 |
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 $87.10 Median $199.53 Typical High $446.68 | Professional | None | $87.10 | $199.53 | $446.68 |
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 $40.74 Median $83.18 Typical High $109.65 | Professional | 52 · Reduced service | $40.74 | $83.18 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $33.11 Typical High $43.65 | Professional | 53 · Discontinued | $16.22 | $33.11 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $123.03 Typical High $165.96 | Professional | 54 · Surgery only | $60.26 | $123.03 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $24.55 Typical High $33.11 | Professional | 55 · Aftercare only | $12.30 | $24.55 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $16.60 Typical High $21.88 | Professional | 56 · Pre-op care only | $8.13 | $16.60 | $21.88 |
Where Georgia sits
The same service costs 3.7 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· 20th of 51
$200
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.