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 $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $239.88 | Professional | None | $229.09 | $229.09 | $239.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $223.87 Median $776.25 Typical High $812.83 | Facility | None | $223.87 | $776.25 | $812.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $190.55 Median $229.09 Typical High $234.42 | Professional | None | $190.55 | $229.09 | $234.42 |
CareSource Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $257.04 Median $416.87 Typical High $616.60 | Facility | None | $257.04 | $416.87 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $257.04 | Professional | None | $229.09 | $229.09 | $257.04 |
Kaiser Permanente Setting Professional Modifier None Typical Low $223.87 Median $288.40 Typical High $758.58 | Professional | None | $223.87 | $288.40 | $758.58 |
Oscar Health Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $251.19 | Professional | None | $223.87 | $223.87 | $251.19 |
United Setting Professional Modifier None Typical Low $223.87 Median $234.42 Typical High $309.03 | Professional | None | $223.87 | $234.42 | $309.03 |
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 $114.82 Median $114.82 Typical High $120.23 | Professional | 52 · Reduced service | $114.82 | $114.82 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $47.86 | Professional | 53 · Discontinued | $45.71 | $45.71 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $36.31 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $23.99 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $23.99 |
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· 36th of 51
$229
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.