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 $36.31 Median $3,548.13 Typical High $7,413.10 | Facility | None | $36.31 | $3,548.13 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $93.33 Typical High $245.47 | Professional | None | $33.11 | $93.33 | $245.47 |
Ambetter Setting Professional Modifier None Typical Low $33.88 Median $64.57 Typical High $199.53 | Professional | None | $33.88 | $64.57 | $199.53 |
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 $30.90 Median $61.66 Typical High $128.82 | Professional | None | $30.90 | $61.66 | $128.82 |
CareSource Setting Professional Modifier None Typical Low $89.13 Median $97.72 Typical High $107.15 | Professional | None | $89.13 | $97.72 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $31.62 Median $31.62 Typical High $70.79 | Facility | None | $31.62 | $31.62 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $14.79 Median $56.23 Typical High $204.17 | Professional | None | $14.79 | $56.23 | $204.17 |
Kaiser Permanente Setting Professional Modifier None Typical Low $34.67 Median $72.44 Typical High $123.03 | Professional | None | $34.67 | $72.44 | $123.03 |
Oscar Health Setting Facility Modifier None Typical Low $229.09 Median $338.84 Typical High $416.87 | Facility | None | $229.09 | $338.84 | $416.87 |
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 $30.20 Median $57.54 Typical High $158.49 | Professional | None | $30.20 | $57.54 | $158.49 |
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 54 · Surgery only Typical Low $24.55 Median $42.66 Typical High $75.86 | Professional | 54 · Surgery only | $24.55 | $42.66 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $8.51 Typical High $15.14 | Professional | 55 · Aftercare only | $4.90 | $8.51 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $5.75 Typical High $10.00 | Professional | 56 · Pre-op care only | $3.31 | $5.75 | $10.00 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | 59 · Distinct service | $154.88 | $154.88 | $154.88 |
Where Georgia sits
The same service costs 2.8 times more in Alaska 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· 29th of 51
$74.13
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.