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 $117.49 Median $134.90 Typical High $162.18 | Facility | None | $117.49 | $134.90 | $162.18 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $154.88 Typical High $346.74 | Professional | None | $117.49 | $154.88 | $346.74 |
Ambetter Setting Professional Modifier None Typical Low $154.88 Median $229.09 Typical High $275.42 | Professional | None | $154.88 | $229.09 | $275.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $128.82 Median $165.96 Typical High $281.84 | Professional | None | $128.82 | $165.96 | $281.84 |
CareSource Setting Professional Modifier None Typical Low $154.88 Median $177.83 Typical High $204.17 | Professional | None | $154.88 | $177.83 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $218.78 Typical High $331.13 | Professional | None | $154.88 | $218.78 | $331.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $141.25 Median $181.97 Typical High $309.03 | Professional | None | $141.25 | $181.97 | $309.03 |
Oscar Health Setting Professional Modifier None Typical Low $114.82 Median $138.04 Typical High $398.11 | Professional | None | $114.82 | $138.04 | $398.11 |
United Setting Professional Modifier None Typical Low $158.49 Median $213.80 Typical High $323.59 | Professional | None | $158.49 | $213.80 | $323.59 |
5 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 $67.61 Median $67.61 Typical High $81.28 | Professional | 52 · Reduced service | $67.61 | $67.61 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $20.42 Typical High $24.55 | Professional | 55 · Aftercare only | $20.42 | $20.42 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $13.49 Typical High $16.22 | Professional | 56 · Pre-op care only | $13.49 | $13.49 | $16.22 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $204.17 Median $269.15 Typical High $275.42 | Professional | 25 · Same-day visit | $204.17 | $269.15 | $275.42 |
Ambetter Setting Professional Modifier FS · Shared visit Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | FS · Shared visit | $269.15 | $269.15 | $269.15 |
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
$170
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.