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 $31.62 Median $3,548.13 Typical High $7,585.78 | Facility | None | $31.62 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $81.28 Typical High $181.97 | Professional | None | $31.62 | $81.28 | $181.97 |
Ambetter Setting Professional Modifier None Typical Low $79.43 Median $138.04 Typical High $154.88 | Professional | None | $79.43 | $138.04 | $154.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $380.19 Median $776.25 Typical High $3,630.78 | Facility | None | $380.19 | $776.25 | $3,630.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $38.90 Median $85.11 Typical High $144.54 | Professional | None | $38.90 | $85.11 | $144.54 |
CareSource Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $97.72 | Professional | None | $91.20 | $91.20 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $67.61 Typical High $199.53 | Facility | None | $54.95 | $67.61 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $83.18 Typical High $186.21 | Professional | None | $34.67 | $83.18 | $186.21 |
Kaiser Permanente Setting Professional Modifier None Typical Low $29.51 Median $79.43 Typical High $134.90 | Professional | None | $29.51 | $79.43 | $134.90 |
United Setting Facility Modifier None Typical Low $79.43 Median $158.49 Typical High $1,778.28 | Facility | None | $79.43 | $158.49 | $1,778.28 |
United Setting Professional Modifier None Typical Low $35.48 Median $85.11 Typical High $190.55 | Professional | None | $35.48 | $85.11 | $190.55 |
6 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 $15.85 Median $38.02 Typical High $45.71 | Professional | 52 · Reduced service | $15.85 | $38.02 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $15.49 Typical High $18.20 | Professional | 53 · Discontinued | $6.31 | $15.49 | $18.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $23.44 Median $57.54 Typical High $69.18 | Professional | 54 · Surgery only | $23.44 | $57.54 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $11.48 Typical High $13.80 | Professional | 55 · Aftercare only | $4.68 | $11.48 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $7.59 Typical High $9.12 | Professional | 56 · Pre-op care only | $3.16 | $7.59 | $9.12 |
Ambetter Setting Professional Modifier 52 · Reduced service Typical Low $32.36 Median $32.36 Typical High $38.02 | Professional | 52 · Reduced service | $32.36 | $32.36 | $38.02 |
Where Georgia sits
The same service costs 3.1 times more in Wisconsin than in Nebraska. 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· 18th of 51
$89.13
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.