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 $33.88 Median $35.48 Typical High $36.31 | Facility | None | $33.88 | $35.48 | $36.31 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $36.31 Typical High $87.10 | Professional | None | $33.88 | $36.31 | $87.10 |
Ambetter Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $21.88 Median $33.11 Typical High $51.29 | Professional | None | $21.88 | $33.11 | $51.29 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | None | $29.51 | $29.51 | $29.51 |
Kaiser Permanente Setting Professional Modifier None Typical Low $21.38 Median $30.20 Typical High $36.31 | Professional | None | $21.38 | $30.20 | $36.31 |
Oscar Health Setting Professional Modifier None Typical Low $24.55 Median $41.69 Typical High $64.57 | Professional | None | $24.55 | $41.69 | $64.57 |
United Setting Professional Modifier None Typical Low $24.55 Median $38.02 Typical High $83.18 | Professional | None | $24.55 | $38.02 | $83.18 |
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 $16.98 Median $18.20 Typical High $19.95 | Professional | 52 · Reduced service | $16.98 | $18.20 | $19.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $7.41 Typical High $7.94 | Professional | 53 · Discontinued | $6.76 | $7.41 | $7.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $5.50 Typical High $5.89 | Professional | 55 · Aftercare only | $5.01 | $5.50 | $5.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.63 Typical High $3.98 | Professional | 56 · Pre-op care only | $3.39 | $3.63 | $3.98 |
Where Georgia sits
The same service costs 3.8 times more in Alaska than in Indiana. 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
$33.88
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.