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 $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $288.40 | Professional | None | $144.54 | $144.54 | $288.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $138.04 Median $416.87 Typical High $501.19 | Facility | None | $138.04 | $416.87 | $501.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $114.82 Median $144.54 Typical High $147.91 | Professional | None | $114.82 | $144.54 | $147.91 |
CareSource Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $263.03 Typical High $389.05 | Facility | None | $162.18 | $263.03 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $162.18 | Professional | None | $144.54 | $144.54 | $162.18 |
Kaiser Permanente Setting Professional Modifier None Typical Low $109.65 Median $151.36 Typical High $302.00 | Professional | None | $109.65 | $151.36 | $302.00 |
Oscar Health Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $154.88 | Professional | None | $138.04 | $138.04 | $154.88 |
United Setting Professional Modifier None Typical Low $138.04 Median $144.54 Typical High $190.55 | Professional | None | $138.04 | $144.54 | $190.55 |
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 $72.44 Median $72.44 Typical High $75.86 | Professional | 52 · Reduced service | $72.44 | $72.44 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $28.84 Typical High $30.20 | Professional | 53 · Discontinued | $28.84 | $28.84 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $21.38 Typical High $22.39 | Professional | 55 · Aftercare only | $21.38 | $21.38 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.45 Typical High $15.14 | Professional | 56 · Pre-op care only | $14.45 | $14.45 | $15.14 |
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· 16th of 51
$145
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.