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 $13.80 Median $13.80 Typical High $21.38 | Facility | None | $13.80 | $13.80 | $21.38 |
Aetna Setting Professional Modifier None Typical Low $13.49 Median $13.80 Typical High $36.31 | Professional | None | $13.49 | $13.80 | $36.31 |
Ambetter Setting Professional Modifier None Typical Low $23.44 Median $29.51 Typical High $30.90 | Professional | None | $23.44 | $29.51 | $30.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $12.02 Median $17.38 Typical High $27.54 | Professional | None | $12.02 | $17.38 | $27.54 |
CareSource Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | None | $14.13 | $14.13 | $14.13 |
Cigna Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | None | $14.79 | $14.79 | $14.79 |
Kaiser Permanente Setting Professional Modifier None Typical Low $15.14 Median $16.22 Typical High $30.90 | Professional | None | $15.14 | $16.22 | $30.90 |
Oscar Health Setting Professional Modifier None Typical Low $16.60 Median $27.54 Typical High $36.31 | Professional | None | $16.60 | $27.54 | $36.31 |
United Setting Professional Modifier None Typical Low $13.49 Median $21.38 Typical High $45.71 | Professional | None | $13.49 | $21.38 | $45.71 |
4 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 $6.76 Median $6.92 Typical High $7.59 | Professional | 52 · Reduced service | $6.76 | $6.92 | $7.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.75 Median $2.75 Typical High $3.02 | Professional | 53 · Discontinued | $2.75 | $2.75 | $3.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.04 Median $2.04 Typical High $2.24 | Professional | 55 · Aftercare only | $2.04 | $2.04 | $2.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.35 Median $1.38 Typical High $1.51 | Professional | 56 · Pre-op care only | $1.35 | $1.38 | $1.51 |
Where Georgia sits
The same service costs 2.8 times more in Alaska than in Louisiana. 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· 26th of 51
$16.60
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.