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 $478.63 Median $478.63 Typical High $549.54 | Facility | None | $478.63 | $478.63 | $549.54 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $562.34 | Professional | None | $478.63 | $478.63 | $562.34 |
Anthem BCBS Setting Professional Modifier None Typical Low $489.78 Median $575.44 Typical High $977.24 | Professional | None | $489.78 | $575.44 | $977.24 |
CareSource Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $660.69 Typical High $1,445.44 | Professional | None | $457.09 | $660.69 | $1,445.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $602.56 Median $758.58 Typical High $3,311.31 | Professional | None | $602.56 | $758.58 | $3,311.31 |
Oscar Health Setting Professional Modifier None Typical Low $549.54 Median $954.99 Typical High $1,230.27 | Professional | None | $549.54 | $954.99 | $1,230.27 |
United Setting Professional Modifier None Typical Low $436.52 Median $676.08 Typical High $1,548.82 | Professional | None | $436.52 | $676.08 | $1,548.82 |
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 $239.88 Median $239.88 Typical High $281.84 | Professional | 52 · Reduced service | $239.88 | $239.88 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $112.20 | Professional | 53 · Discontinued | $97.72 | $97.72 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $85.11 | Professional | 55 · Aftercare only | $72.44 | $72.44 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $47.86 Typical High $56.23 | Professional | 56 · Pre-op care only | $47.86 | $47.86 | $56.23 |
Where Georgia sits
The same service costs 3.2 times more in Alaska than in New York. 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· 23rd of 51
$575
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.