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 $46.77 Median $3,548.13 Typical High $7,585.78 | Facility | None | $46.77 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $91.20 Typical High $223.87 | Professional | None | $44.67 | $91.20 | $223.87 |
Ambetter Setting Professional Modifier None Typical Low $95.50 Median $165.96 Typical High $181.97 | Professional | None | $95.50 | $165.96 | $181.97 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $2,290.87 Typical High $5,888.44 | Facility | None | $741.31 | $2,290.87 | $5,888.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $56.23 Median $117.49 Typical High $177.83 | Professional | None | $56.23 | $117.49 | $177.83 |
CareSource Setting Professional Modifier None Typical Low $79.43 Median $107.15 Typical High $131.83 | Professional | None | $79.43 | $107.15 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $107.15 Typical High $213.80 | Professional | None | $50.12 | $107.15 | $213.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $50.12 Median $112.20 Typical High $295.12 | Professional | None | $50.12 | $112.20 | $295.12 |
Oscar Health Setting Facility Modifier None Typical Low $724.44 Median $891.25 Typical High $1,513.56 | Facility | None | $724.44 | $891.25 | $1,513.56 |
Oscar Health Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
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 $102.33 Typical High $218.78 | Professional | None | $45.71 | $102.33 | $218.78 |
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 $22.39 Median $43.65 Typical High $52.48 | Professional | 52 · Reduced service | $22.39 | $43.65 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $17.38 Typical High $20.89 | Professional | 53 · Discontinued | $8.91 | $17.38 | $20.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.11 Median $66.07 Typical High $77.62 | Professional | 54 · Surgery only | $33.11 | $66.07 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $13.18 Typical High $15.85 | Professional | 55 · Aftercare only | $6.61 | $13.18 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $8.71 Typical High $10.47 | Professional | 56 · Pre-op care only | $4.47 | $8.71 | $10.47 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | 51 · Multiple procedures | $91.20 | $91.20 | $91.20 |
Where Georgia sits
The same service costs 2.5 times more in North Carolina than in Florida. 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· 14th of 51
$112
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.