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 $83.18 Median $83.18 Typical High $177.83 | Facility | None | $83.18 | $83.18 | $177.83 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $83.18 Typical High $87.10 | Professional | None | $72.44 | $83.18 | $87.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $25.12 Median $144.54 Typical High $263.03 | Professional | None | $25.12 | $144.54 | $263.03 |
CareSource Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $102.33 Typical High $363.08 | Professional | None | $81.28 | $102.33 | $363.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $81.28 Median $93.33 Typical High $151.36 | Professional | None | $81.28 | $93.33 | $151.36 |
Oscar Health Setting Professional Modifier None Typical Low $74.13 Median $141.25 Typical High $165.96 | Professional | None | $74.13 | $141.25 | $165.96 |
United Setting Professional Modifier None Typical Low $69.18 Median $97.72 Typical High $323.59 | Professional | None | $69.18 | $97.72 | $323.59 |
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 $36.31 Median $41.69 Typical High $43.65 | Professional | 52 · Reduced service | $36.31 | $41.69 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $16.98 Typical High $17.38 | Professional | 53 · Discontinued | $14.45 | $16.98 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $12.59 Typical High $13.18 | Professional | 55 · Aftercare only | $10.96 | $12.59 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $8.32 Typical High $8.71 | Professional | 56 · Pre-op care only | $7.24 | $8.32 | $8.71 |
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· 22nd of 51
$100
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.