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 $10.00 Median $10.00 Typical High $19.95 | Facility | None | $10.00 | $10.00 | $19.95 |
Aetna Setting Professional Modifier None Typical Low $5.01 Median $10.00 Typical High $20.89 | Professional | None | $5.01 | $10.00 | $20.89 |
Ambetter Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $28.84 | Professional | None | $17.78 | $17.78 | $28.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $7.94 Median $12.30 Typical High $20.42 | Professional | None | $7.94 | $12.30 | $20.42 |
Cigna Setting Professional Modifier None Typical Low $7.59 Median $9.77 Typical High $14.79 | Professional | None | $7.59 | $9.77 | $14.79 |
Kaiser Permanente Setting Professional Modifier None Typical Low $5.01 Median $28.18 Typical High $102.33 | Professional | None | $5.01 | $28.18 | $102.33 |
Oscar Health Setting Facility Modifier None Typical Low $741.31 Median $1,047.13 Typical High $1,318.26 | Facility | None | $741.31 | $1,047.13 | $1,318.26 |
United Setting Professional Modifier None Typical Low $10.00 Median $12.88 Typical High $38.90 | Professional | None | $10.00 | $12.88 | $38.90 |
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 $2.51 Median $5.01 Typical High $5.01 | Professional | 52 · Reduced service | $2.51 | $5.01 | $5.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.00 Median $2.00 Typical High $2.00 | Professional | 53 · Discontinued | $1.00 | $2.00 | $2.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.76 Median $1.51 Typical High $1.51 | Professional | 55 · Aftercare only | $0.76 | $1.51 | $1.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.50 Median $1.00 Typical High $1.00 | Professional | 56 · Pre-op care only | $0.50 | $1.00 | $1.00 |
Anthem BCBS Setting Professional Modifier EP · Child screening program Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | EP · Child screening program | $10.00 | $10.00 | $10.00 |
Where Georgia sits
The same service costs 5.6 times more in Alabama 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· 37th of 51
$12.88
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.