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 $18.20 Median $28.18 Typical High $37.15 | Facility | None | $18.20 | $28.18 | $37.15 |
Aetna Setting Professional Modifier None Typical Low $18.20 Median $28.84 Typical High $52.48 | Professional | None | $18.20 | $28.84 | $52.48 |
Ambetter Setting Professional Modifier None Typical Low $16.60 Median $51.29 Typical High $56.23 | Professional | None | $16.60 | $51.29 | $56.23 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | 50 · Both sides | $75.86 | $75.86 | $75.86 |
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 $17.78 Median $30.20 Typical High $60.26 | Professional | None | $17.78 | $30.20 | $60.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $23.44 Median $38.90 Typical High $85.11 | Professional | 50 · Both sides | $23.44 | $38.90 | $85.11 |
CareSource Setting Professional Modifier None Typical Low $25.70 Median $33.11 Typical High $40.74 | Professional | None | $25.70 | $33.11 | $40.74 |
Cigna Setting Facility Modifier None Typical Low $14.45 Median $18.62 Typical High $87.10 | Facility | None | $14.45 | $18.62 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $20.89 Median $38.90 Typical High $66.07 | Professional | None | $20.89 | $38.90 | $66.07 |
Kaiser Permanente Setting Professional Modifier None Typical Low $17.78 Median $33.11 Typical High $75.86 | Professional | None | $17.78 | $33.11 | $75.86 |
Oscar Health Setting Professional Modifier None Typical Low $26.30 Median $42.66 Typical High $47.86 | Professional | None | $26.30 | $42.66 | $47.86 |
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 $18.62 Median $38.02 Typical High $66.07 | Professional | None | $18.62 | $38.02 | $66.07 |
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 $9.12 Median $12.59 Typical High $15.14 | Professional | 52 · Reduced service | $9.12 | $12.59 | $15.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $5.01 Typical High $6.17 | Professional | 53 · Discontinued | $3.63 | $5.01 | $6.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $3.80 Typical High $4.57 | Professional | 55 · Aftercare only | $2.75 | $3.80 | $4.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $2.51 Typical High $3.09 | Professional | 56 · Pre-op care only | $1.82 | $2.51 | $3.09 |
Ambetter Setting Professional Modifier GP · Physical therapy plan Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | GP · Physical therapy plan | $22.39 | $22.39 | $22.39 |
Where Georgia sits
The same service costs 3.0 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· 36th of 51
$30.90
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.