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 $239.88 Median $3,630.78 Typical High $7,943.28 | Facility | None | $239.88 | $3,630.78 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $269.15 | Professional | None | $229.09 | $229.09 | $269.15 |
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 $223.87 Median $331.13 Typical High $562.34 | Professional | None | $223.87 | $331.13 | $562.34 |
CareSource Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $794.33 Typical High $1,318.26 | Facility | None | $602.56 | $794.33 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $416.87 Typical High $691.83 | Professional | None | $269.15 | $416.87 | $691.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $239.88 Median $269.15 Typical High $1,584.89 | Professional | None | $239.88 | $269.15 | $1,584.89 |
Oscar Health Setting Professional Modifier None Typical Low $213.80 Median $363.08 Typical High $457.09 | Professional | None | $213.80 | $363.08 | $457.09 |
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 $229.09 Median $380.19 Typical High $724.44 | Professional | None | $229.09 | $380.19 | $724.44 |
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 $112.20 Median $112.20 Typical High $134.90 | Professional | 52 · Reduced service | $112.20 | $112.20 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $53.70 | Professional | 53 · Discontinued | $45.71 | $45.71 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $169.82 Typical High $204.17 | Professional | 54 · Surgery only | $169.82 | $169.82 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $40.74 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $26.92 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $26.92 |
Where Georgia sits
The same service costs 4.7 times more in Wyoming 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· 19th of 51
$363
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.