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 $831.76 Median $5,011.87 Typical High $7,943.28 | Facility | None | $831.76 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $371.54 Typical High $707.95 | Professional | None | $354.81 | $371.54 | $707.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $512.86 Median $1,071.52 Typical High $5,754.40 | Facility | None | $512.86 | $1,071.52 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $338.84 Median $512.86 Typical High $851.14 | Professional | None | $338.84 | $512.86 | $851.14 |
CareSource Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,023.29 Typical High $1,380.38 | Facility | None | $524.81 | $1,023.29 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $691.83 Typical High $1,047.13 | Professional | None | $416.87 | $691.83 | $1,047.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $363.08 Median $446.68 Typical High $1,380.38 | Professional | None | $363.08 | $446.68 | $1,380.38 |
Oscar Health Setting Professional Modifier None Typical Low $331.13 Median $562.34 Typical High $741.31 | Professional | None | $331.13 | $562.34 | $741.31 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,479.11 Typical High $5,011.87 | Facility | None | $851.14 | $1,479.11 | $5,011.87 |
United Setting Professional Modifier None Typical Low $354.81 Median $588.84 Typical High $1,122.02 | Professional | None | $354.81 | $588.84 | $1,122.02 |
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 $177.83 Median $177.83 Typical High $223.87 | Professional | 52 · Reduced service | $177.83 | $177.83 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $70.79 Typical High $89.13 | Professional | 53 · Discontinued | $70.79 | $70.79 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $263.03 Typical High $338.84 | Professional | 54 · Surgery only | $263.03 | $263.03 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $52.48 Typical High $67.61 | Professional | 55 · Aftercare only | $52.48 | $52.48 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $35.48 Typical High $44.67 | Professional | 56 · Pre-op care only | $35.48 | $35.48 | $44.67 |
Where Georgia sits
The same service costs 4.8 times more in Alaska than in Utah. 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· 21st of 51
$550
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.