How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $3.31 Median $8.13 Typical High $8.13 | Facility | None | $3.31 | $8.13 | $8.13 |
Aetna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.51 | Professional | None | $8.13 | $8.13 | $8.51 |
Anthem BCBS Setting Facility Modifier None Typical Low $8.13 Median $18.20 Typical High $44.67 | Facility | None | $8.13 | $18.20 | $44.67 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.46 Median $8.13 Typical High $8.32 | Professional | None | $6.46 | $8.13 | $8.32 |
CareSource Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $12.30 | Professional | None | $7.59 | $7.59 | $12.30 |
Cigna Setting Facility Modifier None Typical Low $9.12 Median $14.79 Typical High $21.88 | Facility | None | $9.12 | $14.79 | $21.88 |
Cigna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $9.12 | Professional | None | $8.13 | $8.13 | $9.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3.24 Median $4.68 Typical High $8.71 | Professional | None | $3.24 | $4.68 | $8.71 |
Oscar Health Setting Professional Modifier None Typical Low $7.24 Median $7.24 Typical High $7.24 | Professional | None | $7.24 | $7.24 | $7.24 |
United Setting Professional Modifier None Typical Low $7.24 Median $7.24 Typical High $15.49 | Professional | None | $7.24 | $7.24 | $15.49 |
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 $4.07 Median $4.07 Typical High $4.27 | Professional | 52 · Reduced service | $4.07 | $4.07 | $4.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.62 Median $1.62 Typical High $1.70 | Professional | 53 · Discontinued | $1.62 | $1.62 | $1.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.23 Median $1.23 Typical High $1.29 | Professional | 55 · Aftercare only | $1.23 | $1.23 | $1.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.81 Median $0.81 Typical High $0.85 | Professional | 56 · Pre-op care only | $0.81 | $0.81 | $0.85 |
Where Georgia sits
Rates are fairly even across states for this service. 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· 16th of 51
$8.13
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.