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 $22.91 Median $26.92 Typical High $81.28 | Facility | None | $22.91 | $26.92 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $22.91 Median $54.95 Typical High $83.18 | Professional | None | $22.91 | $54.95 | $83.18 |
Ambetter Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $19.95 Median $25.12 Typical High $57.54 | Professional | None | $19.95 | $25.12 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $67.61 Typical High $141.25 | Professional | None | $25.70 | $67.61 | $141.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $22.39 Median $63.10 Typical High $288.40 | Professional | None | $22.39 | $63.10 | $288.40 |
Oscar Health Setting Professional Modifier None Typical Low $23.99 Median $58.88 Typical High $125.89 | Professional | None | $23.99 | $58.88 | $125.89 |
United Setting Professional Modifier None Typical Low $23.99 Median $72.44 Typical High $162.18 | Professional | None | $23.99 | $72.44 | $162.18 |
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 $11.48 Median $20.89 Typical High $41.69 | Professional | 52 · Reduced service | $11.48 | $20.89 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.57 Median $8.32 Typical High $16.60 | Professional | 53 · Discontinued | $4.57 | $8.32 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.47 Median $6.31 Typical High $12.59 | Professional | 55 · Aftercare only | $3.47 | $6.31 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.29 Median $4.17 Typical High $8.32 | Professional | 56 · Pre-op care only | $2.29 | $4.17 | $8.32 |
Where Georgia sits
The same service costs 4.4 times more in North Dakota than in Kentucky. 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· 50th of 51
$26.92
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.