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 $38.02 Median $38.02 Typical High $38.02 | Facility | None | $38.02 | $38.02 | $38.02 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $77.62 | Professional | None | $38.02 | $38.02 | $77.62 |
Ambetter Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $37.15 Median $125.89 Typical High $134.90 | Facility | None | $37.15 | $125.89 | $134.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.20 Median $38.02 Typical High $38.02 | Professional | None | $30.20 | $38.02 | $38.02 |
CareSource Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $57.54 | Professional | None | $36.31 | $36.31 | $57.54 |
Cigna Setting Facility Modifier None Typical Low $42.66 Median $69.18 Typical High $102.33 | Facility | None | $42.66 | $69.18 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $42.66 | Professional | None | $38.02 | $38.02 | $42.66 |
Kaiser Permanente Setting Professional Modifier None Typical Low $37.15 Median $47.86 Typical High $93.33 | Professional | None | $37.15 | $47.86 | $93.33 |
Oscar Health Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $41.69 | Professional | None | $37.15 | $37.15 | $41.69 |
United Setting Professional Modifier None Typical Low $37.15 Median $38.90 Typical High $51.29 | Professional | None | $37.15 | $38.90 | $51.29 |
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 $18.62 Median $18.62 Typical High $19.95 | Professional | 52 · Reduced service | $18.62 | $18.62 | $19.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $7.59 Typical High $7.94 | Professional | 53 · Discontinued | $7.59 | $7.59 | $7.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $5.62 Typical High $5.89 | Professional | 55 · Aftercare only | $5.62 | $5.62 | $5.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.80 Typical High $3.98 | Professional | 56 · Pre-op care only | $3.80 | $3.80 | $3.98 |
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· 30th of 51
$38.02
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.