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 $138.04 Median $194.98 Typical High $194.98 | Facility | None | $138.04 | $194.98 | $194.98 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $194.98 Typical High $239.88 | Professional | None | $138.04 | $194.98 | $239.88 |
Ambetter Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $190.55 Median $223.87 Typical High $954.99 | Facility | None | $190.55 | $223.87 | $954.99 |
Anthem BCBS Setting Professional Modifier None Typical Low $109.65 Median $194.98 Typical High $194.98 | Professional | None | $109.65 | $194.98 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $245.47 Typical High $389.05 | Facility | None | $213.80 | $245.47 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $114.82 | Professional | None | $85.11 | $85.11 | $114.82 |
Oscar Health Setting Facility Modifier None Typical Low $1,000.00 Median $1,230.27 Typical High $1,318.26 | Facility | None | $1,000.00 | $1,230.27 | $1,318.26 |
United Setting Professional Modifier None Typical Low $190.55 Median $229.09 Typical High $446.68 | Professional | None | $190.55 | $229.09 | $446.68 |
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 $97.72 Median $97.72 Typical High $97.72 | Professional | 52 · Reduced service | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | 53 · Discontinued | $38.90 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | 55 · Aftercare only | $29.51 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | 56 · Pre-op care only | $19.50 | $19.50 | $19.50 |
Where Georgia sits
The same service costs 549.5 times more in Arizona 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· 44th of 51
$195
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.