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 $338.84 Median $338.84 Typical High $338.84 | Facility | None | $338.84 | $338.84 | $338.84 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $524.81 | Professional | None | $338.84 | $338.84 | $524.81 |
Ambetter Setting Professional Modifier None Typical Low $316.23 Median $371.54 Typical High $467.74 | Professional | None | $316.23 | $371.54 | $467.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $316.23 Median $512.86 Typical High $1,148.15 | Facility | None | $316.23 | $512.86 | $1,148.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $245.47 Median $302.00 Typical High $331.13 | Professional | None | $245.47 | $302.00 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $354.81 Median $398.11 Typical High $645.65 | Facility | None | $354.81 | $398.11 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $346.74 | Professional | None | $309.03 | $309.03 | $346.74 |
Oscar Health Setting Facility Modifier None Typical Low $1,000.00 Median $1,202.26 Typical High $1,202.26 | Facility | None | $1,000.00 | $1,202.26 | $1,202.26 |
United Setting Professional Modifier None Typical Low $316.23 Median $389.05 Typical High $707.95 | Professional | None | $316.23 | $389.05 | $707.95 |
4 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 $169.82 Median $169.82 Typical High $169.82 | Professional | 52 · Reduced service | $169.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | 53 · Discontinued | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | 55 · Aftercare only | $51.29 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $33.88 |
Where Georgia sits
The same service costs 2.9 times more in Arizona than in Alabama. 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· 50th of 51
$316
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.