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 $81.28 Median $81.28 Typical High $93.33 | Facility | None | $81.28 | $81.28 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $95.50 | Professional | None | $81.28 | $81.28 | $95.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $87.10 Median $114.82 Typical High $173.78 | Professional | None | $87.10 | $114.82 | $173.78 |
CareSource Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $128.82 Typical High $275.42 | Professional | None | $89.13 | $128.82 | $275.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $85.11 Median $107.15 Typical High $457.09 | Professional | None | $85.11 | $107.15 | $457.09 |
Oscar Health Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
United Setting Professional Modifier None Typical Low $87.10 Median $128.82 Typical High $257.04 | Professional | None | $87.10 | $128.82 | $257.04 |
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 $40.74 Median $40.74 Typical High $47.86 | Professional | 52 · Reduced service | $40.74 | $40.74 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $16.22 Typical High $19.05 | Professional | 53 · Discontinued | $16.22 | $16.22 | $19.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $12.30 Typical High $14.45 | Professional | 55 · Aftercare only | $12.30 | $12.30 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.13 Typical High $9.55 | Professional | 56 · Pre-op care only | $8.13 | $8.13 | $9.55 |
Where Georgia sits
The same service costs 3.1 times more in Alaska than in Florida. 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· 17th of 51
$112
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.