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 $44.67 Median $4,570.88 Typical High $7,413.10 | Facility | None | $44.67 | $4,570.88 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $194.98 Typical High $562.34 | Professional | None | $44.67 | $194.98 | $562.34 |
Ambetter Setting Professional Modifier None Typical Low $37.15 Median $251.19 Typical High $426.58 | Professional | None | $37.15 | $251.19 | $426.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $549.54 Median $831.76 Typical High $1,659.59 | Facility | None | $549.54 | $831.76 | $1,659.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $56.23 Median $190.55 Typical High $363.08 | Professional | None | $56.23 | $190.55 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $144.54 Typical High $478.63 | Professional | None | $51.29 | $144.54 | $478.63 |
Kaiser Permanente Setting Professional Modifier None Typical Low $45.71 Median $245.47 Typical High $323.59 | Professional | None | $45.71 | $245.47 | $323.59 |
Oscar Health Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,778.28 Typical High $2,818.38 | Facility | None | $691.83 | $1,778.28 | $2,818.38 |
United Setting Professional Modifier None Typical Low $45.71 Median $190.55 Typical High $501.19 | Professional | None | $45.71 | $190.55 | $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 $22.39 Median $95.50 Typical High $125.89 | Professional | 52 · Reduced service | $22.39 | $95.50 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $38.90 Typical High $50.12 | Professional | 53 · Discontinued | $8.91 | $38.90 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $28.84 Typical High $38.02 | Professional | 55 · Aftercare only | $6.76 | $28.84 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $19.05 Typical High $25.12 | Professional | 56 · Pre-op care only | $4.47 | $19.05 | $25.12 |
Ambetter Setting Professional Modifier 58 · Staged procedure Typical Low $363.08 Median $363.08 Typical High $426.58 | Professional | 58 · Staged procedure | $363.08 | $363.08 | $426.58 |
Where Georgia sits
The same service costs 5.2 times more in North Carolina than in Hawaii. 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· 23rd of 51
$191
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.