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 $208.93 Median $3,548.13 Typical High $7,585.78 | Facility | None | $208.93 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $208.93 Typical High $239.88 | Professional | None | $83.18 | $208.93 | $239.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $398.11 Median $870.96 Typical High $4,570.88 | Facility | None | $398.11 | $870.96 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $95.50 Median $181.97 Typical High $380.19 | Professional | None | $95.50 | $181.97 | $380.19 |
CareSource Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | None | $79.43 | $79.43 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $1,659.59 Typical High $2,089.30 | Facility | None | $398.11 | $1,659.59 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $194.98 Typical High $467.74 | Professional | None | $97.72 | $194.98 | $467.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $97.72 Median $269.15 Typical High $323.59 | Professional | None | $97.72 | $269.15 | $323.59 |
Oscar Health Setting Professional Modifier None Typical Low $112.20 Median $288.40 Typical High $426.58 | Professional | None | $112.20 | $288.40 | $426.58 |
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 $181.97 Typical High $501.19 | Professional | None | $87.10 | $181.97 | $501.19 |
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 $41.69 Median $97.72 Typical High $117.49 | Professional | 52 · Reduced service | $41.69 | $97.72 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $38.90 Typical High $46.77 | Professional | 53 · Discontinued | $16.60 | $38.90 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $147.91 Typical High $177.83 | Professional | 54 · Surgery only | $63.10 | $147.91 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $29.51 Typical High $35.48 | Professional | 55 · Aftercare only | $12.59 | $29.51 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $19.50 Typical High $23.44 | Professional | 56 · Pre-op care only | $8.32 | $19.50 | $23.44 |
Where Georgia sits
The same service costs 4.5 times more in Alaska than in Washington, DC. 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
$195
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.