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 $60.26 Median $64.57 Typical High $87.10 | Facility | None | $60.26 | $64.57 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $64.57 Typical High $89.13 | Professional | None | $60.26 | $64.57 | $89.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $69.18 Median $114.82 Typical High $165.96 | Facility | None | $69.18 | $114.82 | $165.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $38.90 Median $100.00 Typical High $199.53 | Professional | None | $38.90 | $100.00 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $147.91 Typical High $194.98 | Facility | None | $69.18 | $147.91 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $54.95 Typical High $338.84 | Professional | None | $43.65 | $54.95 | $338.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $67.61 Median $104.71 Typical High $158.49 | Professional | None | $67.61 | $104.71 | $158.49 |
Oscar Health Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | None | $114.82 | $114.82 | $114.82 |
United Setting Professional Modifier None Typical Low $57.54 Median $109.65 Typical High $257.04 | Professional | None | $57.54 | $109.65 | $257.04 |
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 $30.20 Median $31.62 Typical High $43.65 | Professional | 52 · Reduced service | $30.20 | $31.62 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.88 Typical High $17.38 | Professional | 53 · Discontinued | $12.02 | $12.88 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $9.55 Typical High $13.18 | Professional | 55 · Aftercare only | $8.91 | $9.55 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.46 Typical High $8.71 | Professional | 56 · Pre-op care only | $6.03 | $6.46 | $8.71 |
Where Georgia sits
The same service costs 5.0 times more in Alaska than in Alabama. 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
$97.72
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.