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 $269.15 Median $269.15 Typical High $309.03 | Facility | None | $269.15 | $269.15 | $309.03 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $309.03 Typical High $676.08 | Professional | None | $269.15 | $309.03 | $676.08 |
Ambetter Setting Professional Modifier None Typical Low $302.00 Median $501.19 Typical High $575.44 | Professional | None | $302.00 | $501.19 | $575.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $257.04 Median $323.59 Typical High $549.54 | Professional | None | $257.04 | $323.59 | $549.54 |
CareSource Setting Professional Modifier None Typical Low $269.15 Median $371.54 Typical High $446.68 | Professional | None | $269.15 | $371.54 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $346.74 Typical High $812.83 | Professional | None | $239.88 | $346.74 | $812.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $281.84 Median $346.74 Typical High $467.74 | Professional | None | $281.84 | $346.74 | $467.74 |
Oscar Health Setting Professional Modifier None Typical Low $316.23 Median $524.81 Typical High $707.95 | Professional | None | $316.23 | $524.81 | $707.95 |
United Setting Professional Modifier None Typical Low $229.09 Median $354.81 Typical High $851.14 | Professional | None | $229.09 | $354.81 | $851.14 |
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 $134.90 Median $134.90 Typical High $158.49 | Professional | 52 · Reduced service | $134.90 | $134.90 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $53.70 Typical High $63.10 | Professional | 53 · Discontinued | $53.70 | $53.70 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $40.74 Typical High $47.86 | Professional | 55 · Aftercare only | $40.74 | $40.74 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $26.92 Typical High $31.62 | Professional | 56 · Pre-op care only | $26.92 | $26.92 | $31.62 |
Where Georgia sits
The same service costs 2.8 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
$324
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.