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 $35.48 Median $43.65 Typical High $48.98 | Facility | None | $35.48 | $43.65 | $48.98 |
Aetna Setting Professional Modifier None Typical Low $35.48 Median $42.66 Typical High $48.98 | Professional | None | $35.48 | $42.66 | $48.98 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $17.38 Median $20.42 Typical High $23.44 | Professional | 52 · Reduced service | $17.38 | $20.42 | $23.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $8.13 Typical High $9.33 | Professional | 53 · Discontinued | $7.08 | $8.13 | $9.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $6.17 Typical High $7.08 | Professional | 55 · Aftercare only | $5.25 | $6.17 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $4.07 Typical High $4.68 | Professional | 56 · Pre-op care only | $3.55 | $4.07 | $4.68 |
Ambetter Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $83.18 | Professional | None | $40.74 | $40.74 | $83.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $32.36 Median $46.77 Typical High $70.79 | Professional | None | $32.36 | $46.77 | $70.79 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $41.69 Typical High $54.95 | Professional | None | $37.15 | $41.69 | $54.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $26.92 Median $38.02 Typical High $57.54 | Professional | None | $26.92 | $38.02 | $57.54 |
Oscar Health Setting Professional Modifier None Typical Low $31.62 Median $60.26 Typical High $93.33 | Professional | None | $31.62 | $60.26 | $93.33 |
United Setting Professional Modifier None Typical Low $30.20 Median $39.81 Typical High $66.07 | Professional | None | $30.20 | $39.81 | $66.07 |
1 more rate 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier HA · Child/adolescent program Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | HA · Child/adolescent program | $40.74 | $40.74 | $40.74 |
Where Georgia sits
The same service costs 2.9 times more in Alaska than in Kentucky. 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· 30th of 51
$41.69
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.