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 $95.50 Median $109.65 Typical High $128.82 | Facility | None | $95.50 | $109.65 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $117.49 Typical High $269.15 | Professional | None | $95.50 | $117.49 | $269.15 |
Ambetter Setting Professional Modifier None Typical Low $87.10 Median $165.96 Typical High $169.82 | Professional | None | $87.10 | $165.96 | $169.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $91.20 Median $134.90 Typical High $208.93 | Professional | None | $91.20 | $134.90 | $208.93 |
CareSource Setting Professional Modifier None Typical Low $109.65 Median $125.89 Typical High $144.54 | Professional | None | $109.65 | $125.89 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $165.96 Typical High $229.09 | Professional | None | $125.89 | $165.96 | $229.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $89.13 Median $123.03 Typical High $295.12 | Professional | None | $89.13 | $123.03 | $295.12 |
Oscar Health Setting Professional Modifier None Typical Low $93.33 Median $165.96 Typical High $204.17 | Professional | None | $93.33 | $165.96 | $204.17 |
United Setting Professional Modifier None Typical Low $128.82 Median $158.49 Typical High $251.19 | Professional | None | $128.82 | $158.49 | $251.19 |
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 $50.12 Median $51.29 Typical High $57.54 | Professional | 52 · Reduced service | $50.12 | $51.29 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.49 Typical High $17.38 | Professional | 55 · Aftercare only | $15.14 | $15.49 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.23 Typical High $11.48 | Professional | 56 · Pre-op care only | $10.00 | $10.23 | $11.48 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $158.49 Median $165.96 Typical High $169.82 | Professional | 25 · Same-day visit | $158.49 | $165.96 | $169.82 |
Where Georgia sits
The same service costs 2.0 times more in Alaska than in Washington, DC. 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
$135
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.