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 $57.54 Median $3,548.13 Typical High $7,585.78 | Facility | None | $57.54 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $64.57 Typical High $169.82 | Professional | None | $52.48 | $64.57 | $169.82 |
Ambetter Setting Professional Modifier None Typical Low $44.67 Median $46.77 Typical High $89.13 | Professional | None | $44.67 | $46.77 | $89.13 |
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 $45.71 Median $81.28 Typical High $138.04 | Professional | None | $45.71 | $81.28 | $138.04 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $83.18 Median $128.82 Typical High $204.17 | Professional | 50 · Both sides | $83.18 | $128.82 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $25.70 Median $33.88 Typical High $602.56 | Facility | None | $25.70 | $33.88 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $107.15 Typical High $141.25 | Professional | None | $77.62 | $107.15 | $141.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $48.98 Median $64.57 Typical High $141.25 | Professional | None | $48.98 | $64.57 | $141.25 |
Oscar Health Setting Professional Modifier None Typical Low $58.88 Median $67.61 Typical High $77.62 | Professional | None | $58.88 | $67.61 | $77.62 |
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 $58.88 Median $91.20 Typical High $151.36 | Professional | None | $58.88 | $91.20 | $151.36 |
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 $26.30 Median $28.84 Typical High $33.11 | Professional | 52 · Reduced service | $26.30 | $28.84 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $11.48 Typical High $13.18 | Professional | 53 · Discontinued | $10.47 | $11.48 | $13.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $43.65 Typical High $48.98 | Professional | 54 · Surgery only | $39.81 | $43.65 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $8.71 Typical High $10.00 | Professional | 55 · Aftercare only | $7.94 | $8.71 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.75 Typical High $6.61 | Professional | 56 · Pre-op care only | $5.25 | $5.75 | $6.61 |
Where Georgia sits
The same service costs 3.6 times more in Wyoming 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· 14th of 51
$91.20
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.