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 $45.71 Median $58.88 Typical High $58.88 | Facility | None | $45.71 | $58.88 | $58.88 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $58.88 Typical High $138.04 | Professional | None | $45.71 | $58.88 | $138.04 |
Ambetter Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $104.71 | Professional | None | $61.66 | $61.66 | $104.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $44.67 Median $60.26 Typical High $100.00 | Professional | None | $44.67 | $60.26 | $100.00 |
CareSource Setting Professional Modifier None Typical Low $57.54 Median $74.13 Typical High $91.20 | Professional | None | $57.54 | $74.13 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $66.07 Typical High $141.25 | Professional | None | $51.29 | $66.07 | $141.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $42.66 Median $66.07 Typical High $114.82 | Professional | None | $42.66 | $66.07 | $114.82 |
Oscar Health Setting Professional Modifier None Typical Low $70.79 Median $93.33 Typical High $128.82 | Professional | None | $70.79 | $93.33 | $128.82 |
United Setting Professional Modifier None Typical Low $50.12 Median $70.79 Typical High $123.03 | Professional | None | $50.12 | $70.79 | $123.03 |
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 $22.39 Median $26.30 Typical High $31.62 | Professional | 52 · Reduced service | $22.39 | $26.30 | $31.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $7.94 Typical High $9.55 | Professional | 55 · Aftercare only | $6.76 | $7.94 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $5.25 Typical High $6.31 | Professional | 56 · Pre-op care only | $4.47 | $5.25 | $6.31 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $56.23 Median $120.23 Typical High $120.23 | Professional | 25 · Same-day visit | $56.23 | $120.23 | $120.23 |
Ambetter Setting Professional Modifier 33 · Preventive service Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | 33 · Preventive service | $61.66 | $61.66 | $61.66 |
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· 25th of 51
$61.66
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.