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 $147.91 Median $177.83 Typical High $208.93 | Facility | None | $147.91 | $177.83 | $208.93 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $181.97 Typical High $407.38 | Professional | None | $147.91 | $181.97 | $407.38 |
Ambetter Setting Professional Modifier None Typical Low $213.80 Median $323.59 Typical High $407.38 | Professional | None | $213.80 | $323.59 | $407.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $158.49 Median $190.55 Typical High $338.84 | Professional | None | $158.49 | $190.55 | $338.84 |
CareSource Setting Professional Modifier None Typical Low $190.55 Median $251.19 Typical High $309.03 | Professional | None | $190.55 | $251.19 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $239.88 Typical High $457.09 | Professional | None | $181.97 | $239.88 | $457.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $181.97 Median $239.88 Typical High $436.52 | Professional | None | $181.97 | $239.88 | $436.52 |
Oscar Health Setting Professional Modifier None Typical Low $204.17 Median $213.80 Typical High $331.13 | Professional | None | $204.17 | $213.80 | $331.13 |
United Setting Professional Modifier None Typical Low $181.97 Median $251.19 Typical High $398.11 | Professional | None | $181.97 | $251.19 | $398.11 |
7 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 Facility Modifier 52 · Reduced service Typical Low $77.62 Median $91.20 Typical High $109.65 | Facility | 52 · Reduced service | $77.62 | $91.20 | $109.65 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $23.44 Median $26.92 Typical High $33.11 | Facility | 55 · Aftercare only | $23.44 | $26.92 | $33.11 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $15.49 Median $18.20 Typical High $21.88 | Facility | 56 · Pre-op care only | $15.49 | $18.20 | $21.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $77.62 Median $91.20 Typical High $104.71 | Professional | 52 · Reduced service | $77.62 | $91.20 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $26.92 Typical High $31.62 | Professional | 55 · Aftercare only | $23.44 | $26.92 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $18.20 Typical High $21.38 | Professional | 56 · Pre-op care only | $15.49 | $18.20 | $21.38 |
Anthem BCBS Setting Professional Modifier EP · Child screening program Typical Low $181.97 Median $181.97 Typical High $223.87 | Professional | EP · Child screening program | $181.97 | $181.97 | $223.87 |
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· 35th of 51
$195
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.