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 $102.33 Median $102.33 Typical High $117.49 | Facility | None | $102.33 | $102.33 | $117.49 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $117.49 | Professional | None | $102.33 | $102.33 | $117.49 |
Ambetter Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $79.43 Median $120.23 Typical High $208.93 | Professional | None | $79.43 | $120.23 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $154.88 Typical High $338.84 | Professional | None | $112.20 | $154.88 | $338.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $112.20 Median $141.25 Typical High $199.53 | Professional | None | $112.20 | $141.25 | $199.53 |
Oscar Health Setting Professional Modifier None Typical Low $109.65 Median $190.55 Typical High $245.47 | Professional | None | $109.65 | $190.55 | $245.47 |
United Setting Professional Modifier None Typical Low $112.20 Median $181.97 Typical High $316.23 | Professional | None | $112.20 | $181.97 | $316.23 |
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 $51.29 Median $51.29 Typical High $58.88 | Professional | 52 · Reduced service | $51.29 | $51.29 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $20.42 Typical High $23.99 | Professional | 53 · Discontinued | $20.42 | $20.42 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.14 Typical High $17.78 | Professional | 55 · Aftercare only | $15.14 | $15.14 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.23 Typical High $11.75 | Professional | 56 · Pre-op care only | $10.23 | $10.23 | $11.75 |
Where Georgia sits
The same service costs 2.8 times more in Alaska than in Texas. 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· 32nd of 51
$120
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.