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 $18.20 Median $3,630.78 Typical High $7,585.78 | Facility | None | $18.20 | $3,630.78 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $18.20 Median $19.95 Typical High $3,801.89 | Professional | None | $18.20 | $19.95 | $3,801.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $13.49 Median $23.99 Typical High $25.12 | Professional | None | $13.49 | $23.99 | $25.12 |
Cigna Setting Professional Modifier None Typical Low $16.22 Median $19.95 Typical High $26.30 | Professional | None | $16.22 | $19.95 | $26.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $21.38 Median $93.33 Typical High $218.78 | Professional | None | $21.38 | $93.33 | $218.78 |
Oscar Health Setting Facility Modifier None Typical Low $13,182.57 Median $51,286.14 Typical High $54,954.09 | Facility | None | $13,182.57 | $51,286.14 | $54,954.09 |
United Setting Professional Modifier None Typical Low $20.89 Median $29.51 Typical High $54.95 | Professional | None | $20.89 | $29.51 | $54.95 |
5 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 $9.12 Median $9.33 Typical High $10.23 | Professional | 52 · Reduced service | $9.12 | $9.33 | $10.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $3.72 Typical High $4.07 | Professional | 53 · Discontinued | $3.63 | $3.72 | $4.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $2.82 Typical High $3.02 | Professional | 55 · Aftercare only | $2.75 | $2.82 | $3.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $1.86 Typical High $2.04 | Professional | 56 · Pre-op care only | $1.82 | $1.86 | $2.04 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | 59 · Distinct service | $22.91 | $22.91 | $22.91 |
Where Georgia sits
The same service costs 40.7 times more in Tennessee 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· 41st of 51
$23.99
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.