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 $19.95 Median $19.95 Typical High $19.95 | Facility | None | $19.95 | $19.95 | $19.95 |
Aetna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $29.51 | Professional | None | $19.95 | $19.95 | $29.51 |
Anthem BCBS Setting Facility Modifier None Typical Low $19.95 Median $31.62 Typical High $72.44 | Facility | None | $19.95 | $31.62 | $72.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $16.98 Median $20.89 Typical High $22.39 | Professional | None | $16.98 | $20.89 | $22.39 |
Cigna Setting Facility Modifier None Typical Low $21.88 Median $25.12 Typical High $39.81 | Facility | None | $21.88 | $25.12 | $39.81 |
Cigna Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $19.05 Median $19.95 Typical High $77.62 | Professional | None | $19.05 | $19.95 | $77.62 |
Oscar Health Setting Facility Modifier None Typical Low $138.04 Median $208.93 Typical High $257.04 | Facility | None | $138.04 | $208.93 | $257.04 |
United Setting Professional Modifier None Typical Low $22.39 Median $23.44 Typical High $45.71 | Professional | None | $22.39 | $23.44 | $45.71 |
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 $10.00 Median $10.00 Typical High $10.00 | Professional | 52 · Reduced service | $10.00 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | 53 · Discontinued | $3.98 | $3.98 | $3.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | 55 · Aftercare only | $3.02 | $3.02 | $3.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | 56 · Pre-op care only | $2.00 | $2.00 | $2.00 |
Anthem BCBS Setting Professional Modifier EP · Child screening program Typical Low $10.00 Median $22.39 Typical High $22.39 | Professional | EP · Child screening program | $10.00 | $22.39 | $22.39 |
Where Georgia sits
The same service costs 1.9 times more in Alabama than in Rhode Island. 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· 49th of 51
$20.89
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.