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 $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $114.82 | Professional | None | $56.23 | $56.23 | $114.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $53.70 Median $186.21 Typical High $194.98 | Facility | None | $53.70 | $186.21 | $194.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $48.98 Median $56.23 Typical High $66.07 | Professional | None | $48.98 | $56.23 | $66.07 |
CareSource Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $104.71 Typical High $151.36 | Facility | None | $63.10 | $104.71 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $64.57 | Professional | None | $56.23 | $56.23 | $64.57 |
Kaiser Permanente Setting Professional Modifier None Typical Low $53.70 Median $69.18 Typical High $109.65 | Professional | None | $53.70 | $69.18 | $109.65 |
Oscar Health Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $60.26 | Professional | None | $53.70 | $53.70 | $60.26 |
United Setting Professional Modifier None Typical Low $53.70 Median $56.23 Typical High $74.13 | Professional | None | $53.70 | $56.23 | $74.13 |
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 $28.18 Median $28.18 Typical High $29.51 | Professional | 52 · Reduced service | $28.18 | $28.18 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $11.22 Typical High $11.75 | Professional | 53 · Discontinued | $11.22 | $11.22 | $11.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.51 Typical High $8.91 | Professional | 55 · Aftercare only | $8.51 | $8.51 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.62 Typical High $5.89 | Professional | 56 · Pre-op care only | $5.62 | $5.62 | $5.89 |
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
$56.23
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.