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 $14.13 Median $3,548.13 Typical High $7,585.78 | Facility | None | $14.13 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $14.13 Median $15.14 Typical High $38.02 | Professional | None | $14.13 | $15.14 | $38.02 |
Ambetter Setting Professional Modifier None Typical Low $15.14 Median $22.91 Typical High $33.11 | Professional | None | $15.14 | $22.91 | $33.11 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $12.59 Median $32.36 Typical High $50.12 | Professional | 50 · Both sides | $12.59 | $32.36 | $50.12 |
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 $12.88 Median $20.89 Typical High $29.51 | Professional | None | $12.88 | $20.89 | $29.51 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $21.88 Median $31.62 Typical High $47.86 | Professional | 50 · Both sides | $21.88 | $31.62 | $47.86 |
CareSource Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $19.50 | Professional | None | $18.20 | $18.20 | $19.50 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $602.56 Typical High $2,511.89 | Facility | None | $66.07 | $602.56 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $15.14 Median $20.89 Typical High $41.69 | Professional | None | $15.14 | $20.89 | $41.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $17.38 Median $19.95 Typical High $29.51 | Professional | None | $17.38 | $19.95 | $29.51 |
Oscar Health Setting Facility Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,584.89 | Facility | None | $1,288.25 | $1,288.25 | $1,584.89 |
Oscar Health Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
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 $13.49 Median $20.89 Typical High $38.90 | Professional | None | $13.49 | $20.89 | $38.90 |
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 $7.08 Median $7.08 Typical High $7.59 | Professional | 52 · Reduced service | $7.08 | $7.08 | $7.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.82 Median $2.82 Typical High $3.02 | Professional | 53 · Discontinued | $2.82 | $2.82 | $3.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $10.47 Median $10.47 Typical High $11.48 | Professional | 54 · Surgery only | $10.47 | $10.47 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.09 Median $2.09 Typical High $2.29 | Professional | 55 · Aftercare only | $2.09 | $2.09 | $2.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.41 Median $1.41 Typical High $1.51 | Professional | 56 · Pre-op care only | $1.41 | $1.41 | $1.51 |
Where Georgia sits
The same service costs 7.4 times more in Kansas 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· 27th of 51
$21.88
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.