How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $112.20 Median $112.20 Typical High $128.82 | Facility | None | $112.20 | $112.20 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $125.89 Typical High $295.12 | Professional | None | $112.20 | $125.89 | $295.12 |
Ambetter Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $104.71 | Professional | None | $100.00 | $100.00 | $104.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $117.49 Median $154.88 Typical High $239.88 | Professional | None | $117.49 | $154.88 | $239.88 |
CareSource Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | None | $112.20 | $112.20 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $173.78 Typical High $331.13 | Professional | None | $120.23 | $173.78 | $331.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $117.49 Median $151.36 Typical High $380.19 | Professional | None | $117.49 | $151.36 | $380.19 |
Oscar Health Setting Professional Modifier None Typical Low $162.18 Median $181.97 Typical High $186.21 | Professional | None | $162.18 | $181.97 | $186.21 |
United Setting Professional Modifier None Typical Low $114.82 Median $177.83 Typical High $363.08 | Professional | None | $114.82 | $177.83 | $363.08 |
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 $56.23 Median $56.23 Typical High $66.07 | Professional | 52 · Reduced service | $56.23 | $56.23 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $22.39 Typical High $26.30 | Professional | 53 · Discontinued | $22.39 | $22.39 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $16.98 Typical High $19.95 | Professional | 55 · Aftercare only | $16.98 | $16.98 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.22 Typical High $13.18 | Professional | 56 · Pre-op care only | $11.22 | $11.22 | $13.18 |
Where Georgia sits
The same service costs 3.2 times more in Alaska than in Utah. 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· 19th of 51
$151
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.