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 $7.94 Median $8.32 Typical High $20.42 | Facility | None | $7.94 | $8.32 | $20.42 |
Aetna Setting Professional Modifier None Typical Low $7.94 Median $19.50 Typical High $23.99 | Professional | None | $7.94 | $19.50 | $23.99 |
Ambetter Setting Professional Modifier None Typical Low $7.41 Median $7.41 Typical High $7.41 | Professional | None | $7.41 | $7.41 | $7.41 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.32 Median $17.38 Typical High $28.84 | Professional | None | $8.32 | $17.38 | $28.84 |
Cigna Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | None | $22.39 | $22.39 | $22.39 |
Kaiser Permanente Setting Professional Modifier None Typical Low $7.59 Median $22.39 Typical High $38.02 | Professional | None | $7.59 | $22.39 | $38.02 |
Oscar Health Setting Professional Modifier None Typical Low $10.00 Median $11.48 Typical High $30.90 | Professional | None | $10.00 | $11.48 | $30.90 |
United Setting Professional Modifier None Typical Low $8.91 Median $20.42 Typical High $48.98 | Professional | None | $8.91 | $20.42 | $48.98 |
2 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 55 · Aftercare only Typical Low $1.20 Median $1.78 Typical High $3.16 | Professional | 55 · Aftercare only | $1.20 | $1.78 | $3.16 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.79 Median $1.32 Typical High $2.09 | Professional | 56 · Pre-op care only | $0.79 | $1.32 | $2.09 |
Where Georgia sits
The same service costs 3.8 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· 38th of 51
$18.62
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.