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 $128.82 Median $3,548.13 Typical High $7,585.78 | Facility | None | $128.82 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $141.25 Typical High $275.42 | Professional | None | $102.33 | $141.25 | $275.42 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $194.98 Typical High $223.87 | Professional | None | $114.82 | $194.98 | $223.87 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $169.82 Median $309.03 Typical High $331.13 | Professional | 50 · Both sides | $169.82 | $309.03 | $331.13 |
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 $107.15 Median $154.88 Typical High $288.40 | Professional | None | $107.15 | $154.88 | $288.40 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $154.88 Median $223.87 Typical High $426.58 | Professional | 50 · Both sides | $154.88 | $223.87 | $426.58 |
CareSource Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | None | $141.25 | $141.25 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $85.11 Typical High $602.56 | Facility | None | $64.57 | $85.11 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $199.53 Typical High $295.12 | Professional | None | $104.71 | $199.53 | $295.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $95.50 Median $141.25 Typical High $616.60 | Professional | None | $95.50 | $141.25 | $616.60 |
Oscar Health Setting Facility Modifier None Typical Low $575.44 Median $2,290.87 Typical High $2,884.03 | Facility | None | $575.44 | $2,290.87 | $2,884.03 |
Oscar Health Setting Professional Modifier None Typical Low $114.82 Median $144.54 Typical High $213.80 | Professional | None | $114.82 | $144.54 | $213.80 |
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 $100.00 Median $181.97 Typical High $302.00 | Professional | None | $100.00 | $181.97 | $302.00 |
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 $51.29 Median $58.88 Typical High $70.79 | Professional | 52 · Reduced service | $51.29 | $58.88 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $23.44 Typical High $28.84 | Professional | 53 · Discontinued | $20.89 | $23.44 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $89.13 Typical High $107.15 | Professional | 54 · Surgery only | $77.62 | $89.13 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $17.78 Typical High $21.38 | Professional | 55 · Aftercare only | $15.49 | $17.78 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $11.75 Typical High $14.13 | Professional | 56 · Pre-op care only | $10.23 | $11.75 | $14.13 |
Where Georgia sits
The same service costs 3.7 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· 21st 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.