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 $123.03 Median $3,548.13 Typical High $7,585.78 | Facility | None | $123.03 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $123.03 Typical High $309.03 | Professional | None | $83.18 | $123.03 | $309.03 |
Ambetter Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,943.28 Median $7,943.28 Typical High $7,943.28 | Facility | None | $7,943.28 | $7,943.28 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $70.79 Median $114.82 Typical High $177.83 | Professional | None | $70.79 | $114.82 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $741.31 Typical High $3,235.94 | Facility | None | $501.19 | $741.31 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $162.18 Typical High $323.59 | Professional | None | $95.50 | $162.18 | $323.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $93.33 Median $162.18 Typical High $707.95 | Professional | None | $93.33 | $162.18 | $707.95 |
Oscar Health Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
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 $85.11 Median $144.54 Typical High $275.42 | Professional | None | $85.11 | $144.54 | $275.42 |
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 $41.69 Median $52.48 Typical High $66.07 | Professional | 52 · Reduced service | $41.69 | $52.48 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $20.89 Typical High $26.30 | Professional | 53 · Discontinued | $16.60 | $20.89 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $79.43 Typical High $100.00 | Professional | 54 · Surgery only | $63.10 | $79.43 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $15.85 Typical High $19.95 | Professional | 55 · Aftercare only | $12.59 | $15.85 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $10.47 Typical High $13.18 | Professional | 56 · Pre-op care only | $8.32 | $10.47 | $13.18 |
Where Georgia sits
The same service costs 3.5 times more in Alaska 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· 32nd of 51
$126
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.