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 $25.12 Median $25.12 Typical High $25.12 | Facility | None | $25.12 | $25.12 | $25.12 |
Aetna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $64.57 | Professional | None | $25.12 | $25.12 | $64.57 |
Ambetter Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $25.12 Median $56.23 Typical High $134.90 | Facility | None | $25.12 | $56.23 | $134.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $16.60 Median $25.12 Typical High $25.70 | Professional | None | $16.60 | $25.12 | $25.70 |
CareSource Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $45.71 Typical High $66.07 | Facility | None | $34.67 | $45.71 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $28.18 | Professional | None | $25.12 | $25.12 | $28.18 |
Kaiser Permanente Setting Professional Modifier None Typical Low $22.91 Median $45.71 Typical High $52.48 | Professional | None | $22.91 | $45.71 | $52.48 |
Oscar Health Setting Professional Modifier None Typical Low $16.60 Median $22.91 Typical High $25.70 | Professional | None | $16.60 | $22.91 | $25.70 |
United Setting Professional Modifier None Typical Low $16.60 Median $17.78 Typical High $25.12 | Professional | None | $16.60 | $17.78 | $25.12 |
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 $12.30 Median $12.30 Typical High $13.18 | Professional | 52 · Reduced service | $12.30 | $12.30 | $13.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $5.01 Typical High $5.25 | Professional | 53 · Discontinued | $5.01 | $5.01 | $5.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $3.72 Typical High $3.89 | Professional | 55 · Aftercare only | $3.72 | $3.72 | $3.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.45 Typical High $2.63 | Professional | 56 · Pre-op care only | $2.45 | $2.45 | $2.63 |
Where Georgia sits
The same service costs 1.9 times more in Wyoming than in Arizona. 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
$25.12
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.