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 $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $66.07 | Professional | None | $63.10 | $63.10 | $66.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $63.10 Median $141.25 Typical High $346.74 | Facility | None | $63.10 | $141.25 | $346.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $44.67 Median $63.10 Typical High $64.57 | Professional | None | $44.67 | $63.10 | $64.57 |
CareSource Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | None | $57.54 | $57.54 | $57.54 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $114.82 Typical High $169.82 | Facility | None | $70.79 | $114.82 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $70.79 | Professional | None | $63.10 | $63.10 | $70.79 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3.09 Median $33.88 Typical High $69.18 | Professional | None | $3.09 | $33.88 | $69.18 |
Oscar Health Setting Professional Modifier None Typical Low $57.54 Median $64.57 Typical High $102.33 | Professional | None | $57.54 | $64.57 | $102.33 |
United Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $102.33 | Professional | None | $57.54 | $57.54 | $102.33 |
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 $31.62 Median $31.62 Typical High $33.11 | Professional | 52 · Reduced service | $31.62 | $31.62 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $12.59 Typical High $13.18 | Professional | 53 · Discontinued | $12.59 | $12.59 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $9.33 Typical High $10.00 | Professional | 55 · Aftercare only | $9.33 | $9.33 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.31 Typical High $6.61 | Professional | 56 · Pre-op care only | $6.31 | $6.31 | $6.61 |
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· 35th of 51
$63.10
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.