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 $93.33 Median $100.00 Typical High $100.00 | Facility | None | $93.33 | $100.00 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $100.00 Typical High $104.71 | Professional | None | $93.33 | $100.00 | $104.71 |
Ambetter Setting Professional Modifier None Typical Low $75.86 Median $91.20 Typical High $93.33 | Professional | None | $75.86 | $91.20 | $93.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $53.70 Median $93.33 Typical High $120.23 | Professional | None | $53.70 | $93.33 | $120.23 |
CareSource Setting Professional Modifier None Typical Low $89.13 Median $114.82 Typical High $141.25 | Professional | None | $89.13 | $114.82 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Kaiser Permanente Setting Professional Modifier None Typical Low $93.33 Median $100.00 Typical High $331.13 | Professional | None | $93.33 | $100.00 | $331.13 |
Oscar Health Setting Professional Modifier None Typical Low $162.18 Median $181.97 Typical High $218.78 | Professional | None | $162.18 | $181.97 | $218.78 |
United Setting Professional Modifier None Typical Low $79.43 Median $112.20 Typical High $194.98 | Professional | None | $79.43 | $112.20 | $194.98 |
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 $46.77 Median $48.98 Typical High $48.98 | Professional | 52 · Reduced service | $46.77 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $19.95 Typical High $19.95 | Professional | 53 · Discontinued | $18.62 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $14.79 Typical High $14.79 | Professional | 55 · Aftercare only | $14.13 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $10.00 Typical High $10.00 | Professional | 56 · Pre-op care only | $9.33 | $10.00 | $10.00 |
Where Georgia sits
The same service costs 3.3 times more in Alaska than in Kentucky. 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
$95.50
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.