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 $114.82 Median $5,370.32 Typical High $7,585.78 | Facility | None | $114.82 | $5,370.32 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $138.04 Typical High $309.03 | Professional | None | $114.82 | $138.04 | $309.03 |
Ambetter Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
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 $93.33 Median $138.04 Typical High $295.12 | Professional | None | $93.33 | $138.04 | $295.12 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $154.88 Median $208.93 Typical High $446.68 | Professional | 50 · Both sides | $154.88 | $208.93 | $446.68 |
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 $107.15 Median $162.18 Typical High $269.15 | Professional | None | $107.15 | $162.18 | $269.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $107.15 Median $141.25 Typical High $354.81 | Professional | None | $107.15 | $141.25 | $354.81 |
Oscar Health Setting Professional Modifier None Typical Low $128.82 Median $144.54 Typical High $218.78 | Professional | None | $128.82 | $144.54 | $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 $102.33 Median $158.49 Typical High $269.15 | Professional | None | $102.33 | $158.49 | $269.15 |
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 $57.54 Median $64.57 Typical High $72.44 | Professional | 52 · Reduced service | $57.54 | $64.57 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $25.70 Typical High $28.84 | Professional | 53 · Discontinued | $22.91 | $25.70 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $97.72 Typical High $109.65 | Professional | 54 · Surgery only | $85.11 | $97.72 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $19.50 Typical High $21.88 | Professional | 55 · Aftercare only | $16.98 | $19.50 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $12.88 Typical High $14.45 | Professional | 56 · Pre-op care only | $11.48 | $12.88 | $14.45 |
Where Georgia sits
The same service costs 4.5 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· 18th of 51
$155
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.