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 $85.11 Median $5,370.32 Typical High $7,585.78 | Facility | None | $85.11 | $5,370.32 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $199.53 Typical High $630.96 | Professional | None | $85.11 | $199.53 | $630.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $75.86 Median $213.80 Typical High $776.25 | Professional | None | $75.86 | $213.80 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $251.19 Typical High $1,584.89 | Professional | None | $95.50 | $251.19 | $1,584.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $93.33 Median $281.84 Typical High $954.99 | Professional | None | $93.33 | $281.84 | $954.99 |
Oscar Health Setting Professional Modifier None Typical Low $87.10 Median $660.69 Typical High $1,412.54 | Professional | None | $87.10 | $660.69 | $1,412.54 |
United Setting Facility Modifier None Typical Low $1,819.70 Median $3,981.07 Typical High $8,511.38 | Facility | None | $1,819.70 | $3,981.07 | $8,511.38 |
United Setting Professional Modifier None Typical Low $95.50 Median $269.15 Typical High $1,445.44 | Professional | None | $95.50 | $269.15 | $1,445.44 |
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 $42.66 Median $95.50 Typical High $316.23 | Professional | 52 · Reduced service | $42.66 | $95.50 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $38.02 Typical High $125.89 | Professional | 53 · Discontinued | $16.98 | $38.02 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $144.54 Typical High $478.63 | Professional | 54 · Surgery only | $63.10 | $144.54 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $28.84 Typical High $95.50 | Professional | 55 · Aftercare only | $12.88 | $28.84 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $19.05 Typical High $63.10 | Professional | 56 · Pre-op care only | $8.51 | $19.05 | $63.10 |
Where Georgia sits
The same service costs 9.5 times more in Washington than in Washington, DC. 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· 29th of 51
$219
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.