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 $2.95 Median $2.95 Typical High $3.80 | Facility | None | $2.95 | $2.95 | $3.80 |
Aetna Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $6.46 | Professional | None | $2.95 | $2.95 | $6.46 |
Ambetter Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $2.95 | Professional | None | $2.95 | $2.95 | $2.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.95 Median $5.25 Typical High $16.22 | Facility | None | $2.95 | $5.25 | $16.22 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.69 Median $2.95 Typical High $5.89 | Professional | None | $2.69 | $2.95 | $5.89 |
CareSource Setting Professional Modifier None Typical Low $2.82 Median $2.82 Typical High $2.82 | Professional | None | $2.82 | $2.82 | $2.82 |
Cigna Setting Facility Modifier None Typical Low $4.17 Median $5.37 Typical High $7.94 | Facility | None | $4.17 | $5.37 | $7.94 |
Cigna Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $3.31 | Professional | None | $2.95 | $2.95 | $3.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.95 Median $2.69 Typical High $3.16 | Professional | None | $1.95 | $2.69 | $3.16 |
Oscar Health Setting Professional Modifier None Typical Low $2.57 Median $2.69 Typical High $3.02 | Professional | None | $2.57 | $2.69 | $3.02 |
United Setting Professional Modifier None Typical Low $2.69 Median $2.82 Typical High $3.98 | Professional | None | $2.69 | $2.82 | $3.98 |
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 $1.48 Median $1.48 Typical High $1.55 | Professional | 52 · Reduced service | $1.48 | $1.48 | $1.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.59 Median $0.59 Typical High $0.62 | Professional | 53 · Discontinued | $0.59 | $0.59 | $0.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.44 Median $0.44 Typical High $0.46 | Professional | 55 · Aftercare only | $0.44 | $0.44 | $0.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.28 Typical High $0.31 | Professional | 56 · Pre-op care only | $0.28 | $0.28 | $0.31 |
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· 39th of 51
$2.95
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.