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 $169.82 Median $3,548.13 Typical High $7,585.78 | Facility | None | $169.82 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $169.82 Typical High $398.11 | Professional | None | $63.10 | $169.82 | $398.11 |
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 $85.11 Median $154.88 Typical High $288.40 | Professional | None | $85.11 | $154.88 | $288.40 |
CareSource Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $194.98 Typical High $2,290.87 | Facility | None | $144.54 | $194.98 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $158.49 Typical High $380.19 | Professional | None | $74.13 | $158.49 | $380.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $72.44 Median $213.80 Typical High $338.84 | Professional | None | $72.44 | $213.80 | $338.84 |
Oscar Health Setting Professional Modifier None Typical Low $93.33 Median $234.42 Typical High $263.03 | Professional | None | $93.33 | $234.42 | $263.03 |
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 $66.07 Median $151.36 Typical High $407.38 | Professional | None | $66.07 | $151.36 | $407.38 |
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 $31.62 Median $77.62 Typical High $93.33 | Professional | 52 · Reduced service | $31.62 | $77.62 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $30.90 Typical High $37.15 | Professional | 53 · Discontinued | $12.59 | $30.90 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $114.82 Typical High $141.25 | Professional | 54 · Surgery only | $46.77 | $114.82 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $22.91 Typical High $28.18 | Professional | 55 · Aftercare only | $9.55 | $22.91 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $15.14 Typical High $18.62 | Professional | 56 · Pre-op care only | $6.31 | $15.14 | $18.62 |
Where Georgia sits
The same service costs 3.7 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· 16th of 51
$166
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.