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 $177.83 Median $190.55 Typical High $190.55 | Facility | None | $177.83 | $190.55 | $190.55 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $190.55 Typical High $363.08 | Professional | None | $165.96 | $190.55 | $363.08 |
Ambetter Setting Professional Modifier None Typical Low $100.00 Median $117.49 Typical High $239.88 | Professional | None | $100.00 | $117.49 | $239.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $134.90 Median $630.96 Typical High $660.69 | Professional | None | $134.90 | $630.96 | $660.69 |
CareSource Setting Professional Modifier None Typical Low $165.96 Median $223.87 Typical High $269.15 | Professional | None | $165.96 | $223.87 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Facility | None | $269.15 | $269.15 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $208.93 Median $549.54 Typical High $549.54 | Professional | None | $208.93 | $549.54 | $549.54 |
Oscar Health Setting Professional Modifier None Typical Low $251.19 Median $302.00 Typical High $870.96 | Professional | None | $251.19 | $302.00 | $870.96 |
United Setting Professional Modifier None Typical Low $190.55 Median $295.12 Typical High $977.24 | Professional | None | $190.55 | $295.12 | $977.24 |
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 $79.43 Median $95.50 Typical High $95.50 | Professional | 52 · Reduced service | $79.43 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $38.90 Typical High $38.90 | Professional | 53 · Discontinued | $31.62 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $28.84 Typical High $28.84 | Professional | 55 · Aftercare only | $23.44 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $19.05 Typical High $19.05 | Professional | 56 · Pre-op care only | $15.85 | $19.05 | $19.05 |
Where Georgia sits
The same service costs 3.2 times more in Alaska than in Connecticut. 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· 17th of 51
$245
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.