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 $87.10 Median $120.23 Typical High $4,073.80 | Facility | None | $87.10 | $120.23 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $104.71 Typical High $295.12 | Professional | None | $87.10 | $104.71 | $295.12 |
Ambetter Setting Professional Modifier None Typical Low $100.00 Median $138.04 Typical High $204.17 | Professional | None | $100.00 | $138.04 | $204.17 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,621.81 Median $2,884.03 Typical High $4,365.16 | Facility | None | $1,621.81 | $2,884.03 | $4,365.16 |
Anthem BCBS Setting Professional Modifier None Typical Low $100.00 Median $125.89 Typical High $208.93 | Professional | None | $100.00 | $125.89 | $208.93 |
CareSource Setting Professional Modifier None Typical Low $109.65 Median $144.54 Typical High $177.83 | Professional | None | $109.65 | $144.54 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $3,388.44 Median $4,786.30 Typical High $6,025.60 | Facility | None | $3,388.44 | $4,786.30 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $144.54 Typical High $281.84 | Professional | None | $109.65 | $144.54 | $281.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $102.33 Median $162.18 Typical High $204.17 | Professional | None | $102.33 | $162.18 | $204.17 |
Oscar Health Setting Professional Modifier None Typical Low $112.20 Median $194.98 Typical High $295.12 | Professional | None | $112.20 | $194.98 | $295.12 |
United Setting Professional Modifier None Typical Low $107.15 Median $144.54 Typical High $245.47 | Professional | None | $107.15 | $144.54 | $245.47 |
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 $43.65 Median $47.86 Typical High $53.70 | Professional | 52 · Reduced service | $43.65 | $47.86 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $14.45 Typical High $16.22 | Professional | 55 · Aftercare only | $12.88 | $14.45 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $9.55 Typical High $10.72 | Professional | 56 · Pre-op care only | $8.71 | $9.55 | $10.72 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $100.00 Median $190.55 Typical High $204.17 | Professional | 25 · Same-day visit | $100.00 | $190.55 | $204.17 |
Ambetter Setting Professional Modifier FS · Shared visit Typical Low $162.18 Median $162.18 Typical High $165.96 | Professional | FS · Shared visit | $162.18 | $162.18 | $165.96 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | GC · Resident with teaching physician | $204.17 | $204.17 | $204.17 |
Where Georgia sits
The same service costs 2.7 times more in Alaska than in New Jersey. 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
$126
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.