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 $43.65 Median $97.72 Typical High $7,413.10 | Facility | None | $43.65 | $97.72 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $77.62 Typical High $199.53 | Professional | None | $43.65 | $77.62 | $199.53 |
Ambetter Setting Professional Modifier None Typical Low $77.62 Median $147.91 Typical High $158.49 | Professional | None | $77.62 | $147.91 | $158.49 |
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 $42.66 Median $67.61 Typical High $131.83 | Professional | None | $42.66 | $67.61 | $131.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $75.86 Median $109.65 Typical High $199.53 | Professional | 50 · Both sides | $75.86 | $109.65 | $199.53 |
CareSource Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $104.71 | Professional | None | $97.72 | $97.72 | $104.71 |
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 $51.29 Median $100.00 Typical High $208.93 | Professional | None | $51.29 | $100.00 | $208.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $42.66 Median $83.18 Typical High $165.96 | Professional | None | $42.66 | $83.18 | $165.96 |
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 $52.48 Median $104.71 Typical High $199.53 | Professional | None | $52.48 | $104.71 | $199.53 |
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 $21.88 Median $38.02 Typical High $42.66 | Professional | 52 · Reduced service | $21.88 | $38.02 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $15.14 Typical High $16.98 | Professional | 53 · Discontinued | $8.71 | $15.14 | $16.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $32.36 Median $57.54 Typical High $64.57 | Professional | 54 · Surgery only | $32.36 | $57.54 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $11.48 Typical High $12.88 | Professional | 55 · Aftercare only | $6.61 | $11.48 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $7.59 Typical High $8.51 | Professional | 56 · Pre-op care only | $4.37 | $7.59 | $8.51 |
Where Georgia sits
The same service costs 3.3 times more in Alaska than in Kentucky. 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· 45th of 51
$81.28
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.