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 $213.80 Median $3,548.13 Typical High $7,585.78 | Facility | None | $213.80 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $213.80 Typical High $245.47 | Professional | None | $89.13 | $213.80 | $245.47 |
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 $120.23 Median $213.80 Typical High $416.87 | Professional | None | $120.23 | $213.80 | $416.87 |
CareSource Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $758.58 Typical High $1,047.13 | Facility | None | $398.11 | $758.58 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $208.93 Typical High $478.63 | Professional | None | $104.71 | $208.93 | $478.63 |
Kaiser Permanente Setting Professional Modifier None Typical Low $102.33 Median $275.42 Typical High $354.81 | Professional | None | $102.33 | $275.42 | $354.81 |
Oscar Health Setting Professional Modifier None Typical Low $131.83 Median $295.12 Typical High $446.68 | Professional | None | $131.83 | $295.12 | $446.68 |
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 $93.33 Median $194.98 Typical High $512.86 | Professional | None | $93.33 | $194.98 | $512.86 |
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 $44.67 Median $100.00 Typical High $123.03 | Professional | 52 · Reduced service | $44.67 | $100.00 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $40.74 Typical High $48.98 | Professional | 53 · Discontinued | $17.78 | $40.74 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $151.36 Typical High $181.97 | Professional | 54 · Surgery only | $66.07 | $151.36 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $30.20 Typical High $36.31 | Professional | 55 · Aftercare only | $13.18 | $30.20 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $19.95 Typical High $24.55 | Professional | 56 · Pre-op care only | $8.91 | $19.95 | $24.55 |
Where Georgia sits
The same service costs 4.2 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· 19th of 51
$214
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.