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 $117.49 Median $117.49 Typical High $251.19 | Facility | None | $117.49 | $117.49 | $251.19 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $117.49 Typical High $123.03 | Professional | None | $100.00 | $117.49 | $123.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $66.07 Median $186.21 Typical High $363.08 | Professional | None | $66.07 | $186.21 | $363.08 |
CareSource Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $138.04 Typical High $501.19 | Professional | None | $107.15 | $138.04 | $501.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $112.20 Median $131.83 Typical High $213.80 | Professional | None | $112.20 | $131.83 | $213.80 |
Oscar Health Setting Professional Modifier None Typical Low $104.71 Median $194.98 Typical High $229.09 | Professional | None | $104.71 | $194.98 | $229.09 |
United Setting Professional Modifier None Typical Low $91.20 Median $131.83 Typical High $446.68 | Professional | None | $91.20 | $131.83 | $446.68 |
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 $50.12 Median $58.88 Typical High $61.66 | Professional | 52 · Reduced service | $50.12 | $58.88 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $23.44 Typical High $24.55 | Professional | 53 · Discontinued | $20.42 | $23.44 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $17.78 Typical High $18.20 | Professional | 55 · Aftercare only | $15.14 | $17.78 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $11.75 Typical High $12.30 | Professional | 56 · Pre-op care only | $10.00 | $11.75 | $12.30 |
Where Georgia sits
The same service costs 3.0 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· 23rd of 51
$135
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.