How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $107.15 Median $138.04 Typical High $194.98 | Facility | None | $107.15 | $138.04 | $194.98 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $138.04 Typical High $295.12 | Professional | None | $107.15 | $138.04 | $295.12 |
Ambetter Setting Professional Modifier None Typical Low $125.89 Median $162.18 Typical High $302.00 | Professional | None | $125.89 | $162.18 | $302.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $107.15 Median $141.25 Typical High $229.09 | Professional | None | $107.15 | $141.25 | $229.09 |
CareSource Setting Professional Modifier None Typical Low $134.90 Median $177.83 Typical High $218.78 | Professional | None | $134.90 | $177.83 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $154.88 Typical High $338.84 | Professional | None | $112.20 | $154.88 | $338.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $100.00 Median $144.54 Typical High $251.19 | Professional | None | $100.00 | $144.54 | $251.19 |
Oscar Health Setting Professional Modifier None Typical Low $147.91 Median $190.55 Typical High $309.03 | Professional | None | $147.91 | $190.55 | $309.03 |
United Setting Professional Modifier None Typical Low $109.65 Median $154.88 Typical High $295.12 | Professional | None | $109.65 | $154.88 | $295.12 |
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 $53.70 Median $61.66 Typical High $74.13 | Professional | 52 · Reduced service | $53.70 | $61.66 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $18.62 Typical High $22.39 | Professional | 55 · Aftercare only | $15.85 | $18.62 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $12.30 Typical High $14.79 | Professional | 56 · Pre-op care only | $10.72 | $12.30 | $14.79 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $134.90 Median $165.96 Typical High $302.00 | Professional | 25 · Same-day visit | $134.90 | $165.96 | $302.00 |
Ambetter Setting Professional Modifier FP · Family planning Typical Low $151.36 Median $194.98 Typical High $213.80 | Professional | FP · Family planning | $151.36 | $194.98 | $213.80 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | GC · Resident with teaching physician | $190.55 | $190.55 | $190.55 |
Where Georgia sits
The same service costs 2.7 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· 24th of 51
$145
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.