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 $43.65 Median $81.28 Typical High $107.15 | Facility | None | $43.65 | $81.28 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $83.18 Typical High $162.18 | Professional | None | $43.65 | $83.18 | $162.18 |
Ambetter Setting Professional Modifier None Typical Low $40.74 Median $169.82 Typical High $208.93 | Professional | None | $40.74 | $169.82 | $208.93 |
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 $38.90 Median $79.43 Typical High $117.49 | Professional | None | $38.90 | $79.43 | $117.49 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $81.28 Median $120.23 Typical High $181.97 | Professional | 50 · Both sides | $81.28 | $120.23 | $181.97 |
CareSource Setting Professional Modifier None Typical Low $75.86 Median $100.00 Typical High $123.03 | Professional | None | $75.86 | $100.00 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $79.43 Typical High $234.42 | Facility | None | $61.66 | $79.43 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $95.50 Typical High $190.55 | Professional | None | $54.95 | $95.50 | $190.55 |
Kaiser Permanente Setting Professional Modifier None Typical Low $44.67 Median $109.65 Typical High $177.83 | Professional | None | $44.67 | $109.65 | $177.83 |
Oscar Health Setting Professional Modifier None Typical Low $46.77 Median $95.50 Typical High $194.98 | Professional | None | $46.77 | $95.50 | $194.98 |
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 $45.71 Median $87.10 Typical High $208.93 | Professional | None | $45.71 | $87.10 | $208.93 |
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 $21.38 Median $36.31 Typical High $43.65 | Professional | 52 · Reduced service | $21.38 | $36.31 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $14.45 Typical High $17.38 | Professional | 53 · Discontinued | $8.71 | $14.45 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $10.72 Typical High $13.18 | Professional | 55 · Aftercare only | $6.46 | $10.72 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $7.24 Typical High $8.71 | Professional | 56 · Pre-op care only | $4.37 | $7.24 | $8.71 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | GC · Resident with teaching physician | $38.02 | $38.02 | $38.02 |
Where Georgia sits
The same service costs 3.8 times more in Alaska than in Virginia. 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· 27th of 51
$85.11
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.