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 $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $831.76 | Professional | None | $407.38 | $407.38 | $831.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $1,348.96 Typical High $1,445.44 | Facility | None | $389.05 | $1,348.96 | $1,445.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $331.13 Median $407.38 Typical High $416.87 | Professional | None | $331.13 | $407.38 | $416.87 |
CareSource Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
Kaiser Permanente Setting Professional Modifier None Typical Low $302.00 Median $389.05 Typical High $912.01 | Professional | None | $302.00 | $389.05 | $912.01 |
Oscar Health Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $436.52 | Professional | None | $389.05 | $389.05 | $436.52 |
United Setting Professional Modifier None Typical Low $389.05 Median $416.87 Typical High $549.54 | Professional | None | $389.05 | $416.87 | $549.54 |
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 $204.17 Median $204.17 Typical High $213.80 | Professional | 52 · Reduced service | $204.17 | $204.17 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $87.10 | Professional | 53 · Discontinued | $81.28 | $81.28 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $64.57 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $42.66 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $42.66 |
Where Georgia sits
The same service costs 1.5 times more in Alaska than in Oklahoma. 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· 40th of 51
$407
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.