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 $70.79 Median $117.49 Typical High $128.82 | Facility | None | $70.79 | $117.49 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $109.65 Typical High $151.36 | Professional | None | $70.79 | $109.65 | $151.36 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $186.21 Typical High $245.47 | Professional | None | $120.23 | $186.21 | $245.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $54.95 Median $95.50 Typical High $173.78 | Professional | None | $54.95 | $95.50 | $173.78 |
CareSource Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $81.28 Typical High $158.49 | Professional | None | $50.12 | $81.28 | $158.49 |
Kaiser Permanente Setting Professional Modifier None Typical Low $79.43 Median $154.88 Typical High $186.21 | Professional | None | $79.43 | $154.88 | $186.21 |
Oscar Health Setting Facility Modifier None Typical Low $223.87 Median $512.86 Typical High $549.54 | Facility | None | $223.87 | $512.86 | $549.54 |
Oscar Health Setting Professional Modifier None Typical Low $100.00 Median $162.18 Typical High $190.55 | Professional | None | $100.00 | $162.18 | $190.55 |
United Setting Professional Modifier None Typical Low $43.65 Median $87.10 Typical High $154.88 | Professional | None | $43.65 | $87.10 | $154.88 |
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 $35.48 Median $43.65 Typical High $61.66 | Professional | 52 · Reduced service | $35.48 | $43.65 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $13.18 Typical High $18.62 | Professional | 55 · Aftercare only | $10.47 | $13.18 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $8.71 Typical High $12.30 | Professional | 56 · Pre-op care only | $7.08 | $8.71 | $12.30 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $120.23 Median $128.82 Typical High $229.09 | Professional | 25 · Same-day visit | $120.23 | $128.82 | $229.09 |
Where Georgia sits
The same service costs 4.3 times more in Alaska than in North Carolina. 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
$95.50
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.