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 $79.43 Median $89.13 Typical High $134.90 | Facility | None | $79.43 | $89.13 | $134.90 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $134.90 Typical High $251.19 | Professional | None | $77.62 | $134.90 | $251.19 |
Ambetter Setting Professional Modifier None Typical Low $70.79 Median $114.82 Typical High $144.54 | Professional | None | $70.79 | $114.82 | $144.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $72.44 Median $91.20 Typical High $169.82 | Professional | None | $72.44 | $91.20 | $169.82 |
CareSource Setting Professional Modifier None Typical Low $91.20 Median $104.71 Typical High $123.03 | Professional | None | $91.20 | $104.71 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $123.03 Typical High $194.98 | Professional | None | $85.11 | $123.03 | $194.98 |
Kaiser Permanente Setting Professional Modifier None Typical Low $75.86 Median $104.71 Typical High $165.96 | Professional | None | $75.86 | $104.71 | $165.96 |
Oscar Health Setting Professional Modifier None Typical Low $79.43 Median $141.25 Typical High $173.78 | Professional | None | $79.43 | $141.25 | $173.78 |
United Setting Professional Modifier None Typical Low $85.11 Median $125.89 Typical High $190.55 | Professional | None | $85.11 | $125.89 | $190.55 |
6 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 $38.90 Median $39.81 Typical High $43.65 | Professional | 52 · Reduced service | $38.90 | $39.81 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $11.75 Typical High $13.18 | Professional | 55 · Aftercare only | $11.75 | $11.75 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $7.94 Typical High $8.71 | Professional | 56 · Pre-op care only | $7.76 | $7.94 | $8.71 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $114.82 Median $141.25 Typical High $144.54 | Professional | 25 · Same-day visit | $114.82 | $141.25 | $144.54 |
Ambetter Setting Professional Modifier 57 · Decision for surgery Typical Low $85.11 Median $138.04 Typical High $144.54 | Professional | 57 · Decision for surgery | $85.11 | $138.04 | $144.54 |
Ambetter Setting Professional Modifier FS · Shared visit Typical Low $114.82 Median $141.25 Typical High $426.58 | Professional | FS · Shared visit | $114.82 | $141.25 | $426.58 |
Where Georgia sits
The same service costs 2.3 times more in Alaska than in Alabama. 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· 30th of 51
$105
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.