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 $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $114.82 | Professional | None | $57.54 | $57.54 | $114.82 |
Ambetter Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | None | $57.54 | $57.54 | $57.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $54.95 Median $165.96 Typical High $204.17 | Facility | None | $54.95 | $165.96 | $204.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $44.67 Median $57.54 Typical High $57.54 | Professional | None | $44.67 | $57.54 | $57.54 |
CareSource Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $89.13 | Professional | None | $54.95 | $54.95 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $104.71 Typical High $154.88 | Facility | None | $64.57 | $104.71 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $64.57 | Professional | None | $57.54 | $57.54 | $64.57 |
Kaiser Permanente Setting Professional Modifier None Typical Low $54.95 Median $70.79 Typical High $114.82 | Professional | None | $54.95 | $70.79 | $114.82 |
Oscar Health Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $61.66 | Professional | None | $54.95 | $54.95 | $61.66 |
United Setting Professional Modifier None Typical Low $54.95 Median $58.88 Typical High $77.62 | Professional | None | $54.95 | $58.88 | $77.62 |
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 $28.84 Median $28.84 Typical High $30.20 | Professional | 52 · Reduced service | $28.84 | $28.84 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $11.48 Typical High $12.02 | Professional | 53 · Discontinued | $11.48 | $11.48 | $12.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.51 Typical High $8.91 | Professional | 55 · Aftercare only | $8.51 | $8.51 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $5.75 Typical High $6.03 | Professional | 56 · Pre-op care only | $5.75 | $5.75 | $6.03 |
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· 34th of 51
$57.54
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.