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 $208.93 Median $5,370.32 Typical High $8,128.31 | Facility | None | $208.93 | $5,370.32 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $213.80 Typical High $549.54 | Professional | None | $114.82 | $213.80 | $549.54 |
Ambetter Setting Professional Modifier None Typical Low $398.11 Median $416.87 Typical High $436.52 | Professional | None | $398.11 | $416.87 | $436.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $1,288.25 Typical High $4,570.88 | Facility | None | $724.44 | $1,288.25 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $162.18 Median $302.00 Typical High $933.25 | Professional | None | $162.18 | $302.00 | $933.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $245.47 Median $446.68 Typical High $1,412.54 | Professional | 50 · Both sides | $245.47 | $446.68 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $194.98 Typical High $1,288.25 | Facility | None | $147.91 | $194.98 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $281.84 Typical High $776.25 | Professional | None | $134.90 | $281.84 | $776.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $109.65 Median $229.09 Typical High $457.09 | Professional | None | $109.65 | $229.09 | $457.09 |
United Setting Facility Modifier None Typical Low $501.19 Median $724.44 Typical High $3,548.13 | Facility | None | $501.19 | $724.44 | $3,548.13 |
United Setting Professional Modifier None Typical Low $134.90 Median $288.40 Typical High $912.01 | Professional | None | $134.90 | $288.40 | $912.01 |
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 $104.71 Typical High $117.49 | Professional | 52 · Reduced service | $57.54 | $104.71 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $41.69 Typical High $46.77 | Professional | 53 · Discontinued | $22.91 | $41.69 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $158.49 Typical High $177.83 | Professional | 54 · Surgery only | $85.11 | $158.49 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $31.62 Typical High $35.48 | Professional | 55 · Aftercare only | $16.98 | $31.62 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $20.89 Typical High $23.44 | Professional | 56 · Pre-op care only | $11.48 | $20.89 | $23.44 |
Where Georgia sits
The same service costs 3.2 times more in Oklahoma than in Texas. 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· 17th of 51
$302
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.