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 $56.23 Median $81.28 Typical High $93.33 | Facility | None | $56.23 | $81.28 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $81.28 Typical High $158.49 | Professional | None | $56.23 | $81.28 | $158.49 |
Ambetter Setting Professional Modifier None Typical Low $60.26 Median $81.28 Typical High $134.90 | Professional | None | $60.26 | $81.28 | $134.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $63.10 Median $79.43 Typical High $141.25 | Professional | None | $63.10 | $79.43 | $141.25 |
CareSource Setting Professional Modifier None Typical Low $89.13 Median $102.33 Typical High $117.49 | Professional | None | $89.13 | $102.33 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $91.20 Typical High $186.21 | Professional | None | $70.79 | $91.20 | $186.21 |
Kaiser Permanente Setting Professional Modifier None Typical Low $72.44 Median $97.72 Typical High $154.88 | Professional | None | $72.44 | $97.72 | $154.88 |
Oscar Health Setting Professional Modifier None Typical Low $74.13 Median $131.83 Typical High $162.18 | Professional | None | $74.13 | $131.83 | $162.18 |
United Setting Professional Modifier None Typical Low $69.18 Median $93.33 Typical High $158.49 | Professional | None | $69.18 | $93.33 | $158.49 |
9 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 $28.18 Median $28.18 Typical High $33.11 | Professional | 52 · Reduced service | $28.18 | $28.18 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.51 Typical High $10.00 | Professional | 55 · Aftercare only | $8.51 | $8.51 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.62 Typical High $6.61 | Professional | 56 · Pre-op care only | $5.62 | $5.62 | $6.61 |
Ambetter Setting Professional Modifier 24 · Unrelated visit after surgery Typical Low $107.15 Median $131.83 Typical High $138.04 | Professional | 24 · Unrelated visit after surgery | $107.15 | $131.83 | $138.04 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $81.28 Median $125.89 Typical High $138.04 | Professional | 25 · Same-day visit | $81.28 | $125.89 | $138.04 |
Ambetter Setting Professional Modifier 57 · Decision for surgery Typical Low $69.18 Median $131.83 Typical High $134.90 | Professional | 57 · Decision for surgery | $69.18 | $131.83 | $134.90 |
Ambetter Setting Professional Modifier FS · Shared visit Typical Low $69.18 Median $107.15 Typical High $138.04 | Professional | FS · Shared visit | $69.18 | $107.15 | $138.04 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $70.79 Median $134.90 Typical High $138.04 | Professional | GC · Resident with teaching physician | $70.79 | $134.90 | $138.04 |
Ambetter Setting Professional Modifier GW · Unrelated to hospice condition Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | GW · Unrelated to hospice condition | $74.13 | $74.13 | $74.13 |
Where Georgia sits
The same service costs 2.4 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· 25th of 51
$79.43
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.