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 $165.96 Median $3,548.13 Typical High $7,585.78 | Facility | None | $165.96 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $169.82 Typical High $478.63 | Professional | None | $66.07 | $169.82 | $478.63 |
Ambetter Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
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 $72.44 Median $138.04 Typical High $275.42 | Professional | None | $72.44 | $138.04 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $151.36 Typical High $363.08 | Professional | None | $69.18 | $151.36 | $363.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $52.48 Median $165.96 Typical High $478.63 | Professional | None | $52.48 | $165.96 | $478.63 |
Oscar Health Setting Professional Modifier None Typical Low $69.18 Median $181.97 Typical High $208.93 | Professional | None | $69.18 | $181.97 | $208.93 |
United Setting Professional Modifier None Typical Low $75.86 Median $181.97 Typical High $398.11 | Professional | None | $75.86 | $181.97 | $398.11 |
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 $33.11 Median $79.43 Typical High $89.13 | Professional | 52 · Reduced service | $33.11 | $79.43 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $31.62 Typical High $35.48 | Professional | 53 · Discontinued | $13.18 | $31.62 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $120.23 Typical High $134.90 | Professional | 54 · Surgery only | $50.12 | $120.23 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $23.99 Typical High $26.92 | Professional | 55 · Aftercare only | $10.00 | $23.99 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $15.85 Typical High $17.78 | Professional | 56 · Pre-op care only | $6.61 | $15.85 | $17.78 |
Where Georgia sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 18th of 51
$166
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.