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 $194.98 Median $194.98 Typical High $416.87 | Facility | None | $194.98 | $194.98 | $416.87 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $194.98 Typical High $204.17 | Professional | None | $169.82 | $194.98 | $204.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $75.86 Median $338.84 Typical High $602.56 | Professional | None | $75.86 | $338.84 | $602.56 |
CareSource Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $239.88 Typical High $831.76 | Professional | None | $186.21 | $239.88 | $831.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $186.21 Median $213.80 Typical High $346.74 | Professional | None | $186.21 | $213.80 | $346.74 |
Oscar Health Setting Professional Modifier None Typical Low $169.82 Median $323.59 Typical High $380.19 | Professional | None | $169.82 | $323.59 | $380.19 |
United Setting Professional Modifier None Typical Low $154.88 Median $229.09 Typical High $741.31 | Professional | None | $154.88 | $229.09 | $741.31 |
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 $85.11 Median $97.72 Typical High $102.33 | Professional | 52 · Reduced service | $85.11 | $97.72 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $38.90 Typical High $40.74 | Professional | 53 · Discontinued | $33.88 | $38.90 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $29.51 Typical High $30.20 | Professional | 55 · Aftercare only | $25.12 | $29.51 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $19.50 Typical High $20.42 | Professional | 56 · Pre-op care only | $16.98 | $19.50 | $20.42 |
Where Georgia sits
The same service costs 2.9 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
$229
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.