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 $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $478.63 | Professional | None | $204.17 | $204.17 | $478.63 |
Anthem BCBS Setting Facility Modifier None Typical Low $199.53 Median $616.60 Typical High $741.31 | Facility | None | $199.53 | $616.60 | $741.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $204.17 Typical High $208.93 | Professional | None | $169.82 | $204.17 | $208.93 |
CareSource Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $380.19 Typical High $549.54 | Facility | None | $234.42 | $380.19 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $234.42 | Professional | None | $204.17 | $204.17 | $234.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $199.53 Median $263.03 Typical High $501.19 | Professional | None | $199.53 | $263.03 | $501.19 |
Oscar Health Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $229.09 | Professional | None | $199.53 | $199.53 | $229.09 |
United Setting Professional Modifier None Typical Low $199.53 Median $213.80 Typical High $281.84 | Professional | None | $199.53 | $213.80 | $281.84 |
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 $102.33 Median $102.33 Typical High $107.15 | Professional | 52 · Reduced service | $102.33 | $102.33 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $40.74 Typical High $43.65 | Professional | 53 · Discontinued | $40.74 | $40.74 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $30.90 Typical High $32.36 | Professional | 55 · Aftercare only | $30.90 | $30.90 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.42 Typical High $21.38 | Professional | 56 · Pre-op care only | $20.42 | $20.42 | $21.38 |
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· 35th of 51
$204
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.