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 $407.38 Median $426.58 Typical High $426.58 | Facility | None | $407.38 | $426.58 | $426.58 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $407.38 Typical High $426.58 | Professional | None | $288.40 | $407.38 | $426.58 |
Ambetter Setting Professional Modifier None Typical Low $389.05 Median $691.83 Typical High $691.83 | Professional | None | $389.05 | $691.83 | $691.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $346.74 Median $426.58 Typical High $645.65 | Professional | None | $346.74 | $426.58 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $363.08 Median $478.63 Typical High $851.14 | Professional | None | $363.08 | $478.63 | $851.14 |
Oscar Health Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $616.60 | Professional | None | $416.87 | $416.87 | $616.60 |
United Setting Professional Modifier None Typical Low $302.00 Median $467.74 Typical High $1,258.93 | Professional | None | $302.00 | $467.74 | $1,258.93 |
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 $199.53 Median $213.80 Typical High $213.80 | Professional | 52 · Reduced service | $199.53 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $85.11 Typical High $85.11 | Professional | 53 · Discontinued | $79.43 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $63.10 Typical High $63.10 | Professional | 55 · Aftercare only | $60.26 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $42.66 Typical High $42.66 | Professional | 56 · Pre-op care only | $39.81 | $42.66 | $42.66 |
Where Georgia sits
The same service costs 2.1 times more in Wyoming than in Maryland. 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· 22nd of 51
$427
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.