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 $60.26 Median $3,548.13 Typical High $7,585.78 | Facility | None | $60.26 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $75.86 Typical High $190.55 | Professional | None | $54.95 | $75.86 | $190.55 |
Ambetter Setting Professional Modifier None Typical Low $66.07 Median $144.54 Typical High $158.49 | Professional | None | $66.07 | $144.54 | $158.49 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $95.50 Median $239.88 Typical High $239.88 | Professional | 50 · Both sides | $95.50 | $239.88 | $239.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $371.54 Median $758.58 Typical High $3,630.78 | Facility | None | $371.54 | $758.58 | $3,630.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $54.95 Median $87.10 Typical High $158.49 | Professional | None | $54.95 | $87.10 | $158.49 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $93.33 Median $138.04 Typical High $251.19 | Professional | 50 · Both sides | $93.33 | $138.04 | $251.19 |
CareSource Setting Professional Modifier None Typical Low $67.61 Median $89.13 Typical High $109.65 | Professional | None | $67.61 | $89.13 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $41.69 Median $54.95 Typical High $602.56 | Facility | None | $41.69 | $54.95 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $114.82 Typical High $204.17 | Professional | None | $61.66 | $114.82 | $204.17 |
Kaiser Permanente Setting Professional Modifier None Typical Low $60.26 Median $97.72 Typical High $173.78 | Professional | None | $60.26 | $97.72 | $173.78 |
Oscar Health Setting Professional Modifier None Typical Low $77.62 Median $109.65 Typical High $123.03 | Professional | None | $77.62 | $109.65 | $123.03 |
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 $56.23 Median $102.33 Typical High $181.97 | Professional | None | $56.23 | $102.33 | $181.97 |
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 $27.54 Median $37.15 Typical High $41.69 | Professional | 52 · Reduced service | $27.54 | $37.15 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $14.79 Typical High $16.60 | Professional | 53 · Discontinued | $10.96 | $14.79 | $16.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $54.95 Typical High $61.66 | Professional | 54 · Surgery only | $40.74 | $54.95 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $10.96 Typical High $12.30 | Professional | 55 · Aftercare only | $8.13 | $10.96 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $7.41 Typical High $8.32 | Professional | 56 · Pre-op care only | $5.50 | $7.41 | $8.32 |
Where Georgia sits
The same service costs 3.2 times more in Alaska than in Texas. 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· 26th of 51
$93.33
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.