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 $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $89.13 | Professional | None | $60.26 | $60.26 | $89.13 |
Ambetter Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $56.23 Median $169.82 Typical High $204.17 | Facility | None | $56.23 | $169.82 | $204.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $46.77 Median $60.26 Typical High $61.66 | Professional | None | $46.77 | $60.26 | $61.66 |
CareSource Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $89.13 | Professional | None | $56.23 | $56.23 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $112.20 Typical High $162.18 | Facility | None | $67.61 | $112.20 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $67.61 | Professional | None | $60.26 | $60.26 | $67.61 |
Kaiser Permanente Setting Professional Modifier None Typical Low $39.81 Median $56.23 Typical High $100.00 | Professional | None | $39.81 | $56.23 | $100.00 |
Oscar Health Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $63.10 | Professional | None | $56.23 | $56.23 | $63.10 |
United Setting Professional Modifier None Typical Low $56.23 Median $60.26 Typical High $79.43 | Professional | None | $56.23 | $60.26 | $79.43 |
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 $30.20 Median $30.20 Typical High $31.62 | Professional | 52 · Reduced service | $30.20 | $30.20 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.02 Typical High $12.59 | Professional | 53 · Discontinued | $12.02 | $12.02 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $9.12 Typical High $9.55 | Professional | 55 · Aftercare only | $9.12 | $9.12 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.03 Typical High $6.31 | Professional | 56 · Pre-op care only | $6.03 | $6.03 | $6.31 |
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· 24th of 51
$60.26
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.