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 $3,467.37 Median $3,467.37 Typical High $3,467.37 | Facility | None | $3,467.37 | $3,467.37 | $3,467.37 |
Aetna Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $3,467.37 | Professional | None | $3,467.37 | $3,467.37 | $3,467.37 |
Ambetter Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,412.54 | $1,412.54 | $1,412.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,584.89 Median $5,495.41 Typical High $6,456.54 | Facility | None | $1,584.89 | $5,495.41 | $6,456.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,388.44 Median $3,801.89 Typical High $3,981.07 | Professional | None | $3,388.44 | $3,801.89 | $3,981.07 |
Cigna Setting Facility Modifier None Typical Low $3,548.13 Median $4,073.80 Typical High $6,456.54 | Facility | None | $3,548.13 | $4,073.80 | $6,456.54 |
Cigna Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Professional | None | $3,548.13 | $3,548.13 | $3,548.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,548.13 Median $3,890.45 Typical High $5,128.61 | Professional | None | $3,548.13 | $3,890.45 | $5,128.61 |
Oscar Health Setting Professional Modifier None Typical Low $5,370.32 Median $6,165.95 Typical High $7,244.36 | Professional | None | $5,370.32 | $6,165.95 | $7,244.36 |
United Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $5,370.32 | Professional | None | $3,467.37 | $3,467.37 | $5,370.32 |
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 $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | 52 · Reduced service | $1,737.80 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | 53 · Discontinued | $691.83 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $512.86 Median $524.81 Typical High $524.81 | Professional | 55 · Aftercare only | $512.86 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | 56 · Pre-op care only | $346.74 | $346.74 | $346.74 |
Where Georgia sits
The same service costs 1.6 times more in North Carolina than in Nebraska. 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· 14th of 51
$3,548
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.