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 $43.65 Median $43.65 Typical High $44.67 | Facility | None | $43.65 | $43.65 | $44.67 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $87.10 | Professional | None | $43.65 | $43.65 | $87.10 |
Ambetter Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $42.66 Median $128.82 Typical High $154.88 | Facility | None | $42.66 | $128.82 | $154.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $34.67 Median $43.65 Typical High $44.67 | Professional | None | $34.67 | $43.65 | $44.67 |
CareSource Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $67.61 | Professional | None | $41.69 | $41.69 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $79.43 Typical High $117.49 | Facility | None | $48.98 | $79.43 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $48.98 | Professional | None | $43.65 | $43.65 | $48.98 |
Kaiser Permanente Setting Professional Modifier None Typical Low $30.90 Median $42.66 Typical High $89.13 | Professional | None | $30.90 | $42.66 | $89.13 |
Oscar Health Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $47.86 | Professional | None | $42.66 | $42.66 | $47.86 |
United Setting Professional Modifier None Typical Low $42.66 Median $44.67 Typical High $58.88 | Professional | None | $42.66 | $44.67 | $58.88 |
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 $21.88 Median $21.88 Typical High $21.88 | Professional | 52 · Reduced service | $21.88 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | 53 · Discontinued | $8.71 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $6.61 Typical High $6.61 | Professional | 55 · Aftercare only | $6.61 | $6.61 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | 56 · Pre-op care only | $4.37 | $4.37 | $4.37 |
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· 36th of 51
$43.65
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.