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 $190.55 Median $190.55 Typical High $204.17 | Facility | None | $190.55 | $190.55 | $204.17 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $416.87 | Professional | None | $190.55 | $190.55 | $416.87 |
Ambetter Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $186.21 Median $645.65 Typical High $691.83 | Facility | None | $186.21 | $645.65 | $691.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $151.36 Median $190.55 Typical High $194.98 | Professional | None | $151.36 | $190.55 | $194.98 |
CareSource Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $295.12 | Professional | None | $181.97 | $181.97 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $346.74 Typical High $512.86 | Facility | None | $213.80 | $346.74 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $213.80 | Professional | None | $190.55 | $190.55 | $213.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $151.36 Median $186.21 Typical High $398.11 | Professional | None | $151.36 | $186.21 | $398.11 |
Oscar Health Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $208.93 | Professional | None | $186.21 | $186.21 | $208.93 |
United Setting Professional Modifier None Typical Low $186.21 Median $199.53 Typical High $263.03 | Professional | None | $186.21 | $199.53 | $263.03 |
5 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 $95.50 Median $95.50 Typical High $95.50 | Professional | 52 · Reduced service | $95.50 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $38.90 | Professional | 53 · Discontinued | $38.02 | $38.02 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | 55 · Aftercare only | $28.84 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $19.05 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | JZ · No drug discarded | $354.81 | $354.81 | $354.81 |
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· 21st of 51
$191
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.