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 $54.95 Median $3,019.95 Typical High $7,413.10 | Facility | None | $54.95 | $3,019.95 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $89.13 Typical High $186.21 | Professional | None | $41.69 | $89.13 | $186.21 |
Ambetter Setting Professional Modifier None Typical Low $47.86 Median $109.65 Typical High $234.42 | Professional | None | $47.86 | $109.65 | $234.42 |
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 $63.10 Median $114.82 Typical High $190.55 | Professional | None | $63.10 | $114.82 | $190.55 |
CareSource Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $141.25 | Professional | None | $128.82 | $128.82 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $346.74 Typical High $4,265.80 | Facility | None | $50.12 | $346.74 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $107.15 Typical High $239.88 | Professional | None | $56.23 | $107.15 | $239.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $48.98 Median $112.20 Typical High $181.97 | Professional | None | $48.98 | $112.20 | $181.97 |
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 $54.95 Median $104.71 Typical High $239.88 | Professional | None | $54.95 | $104.71 | $239.88 |
9 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 $20.89 Median $42.66 Typical High $54.95 | Professional | 52 · Reduced service | $20.89 | $42.66 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $16.98 Typical High $21.88 | Professional | 53 · Discontinued | $8.32 | $16.98 | $21.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.90 Median $63.10 Typical High $83.18 | Professional | 54 · Surgery only | $30.90 | $63.10 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $12.59 Typical High $16.60 | Professional | 55 · Aftercare only | $6.17 | $12.59 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $8.51 Typical High $10.96 | Professional | 56 · Pre-op care only | $4.17 | $8.51 | $10.96 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $32.36 Median $56.23 Typical High $102.33 | Professional | 51 · Multiple procedures | $32.36 | $56.23 | $102.33 |
Ambetter Setting Professional Modifier 52 · Reduced service Typical Low $16.22 Median $19.95 Typical High $66.07 | Professional | 52 · Reduced service | $16.22 | $19.95 | $66.07 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $81.28 Median $85.11 Typical High $257.04 | Professional | 59 · Distinct service | $81.28 | $85.11 | $257.04 |
Ambetter Setting Professional Modifier FP · Family planning Typical Low $48.98 Median $100.00 Typical High $147.91 | Professional | FP · Family planning | $48.98 | $100.00 | $147.91 |
Where Georgia sits
The same service costs 3.2 times more in Alaska than in New York. 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
$115
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.