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 $58.88 Median $58.88 Typical High $58.88 | Facility | None | $58.88 | $58.88 | $58.88 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $154.88 | Professional | None | $58.88 | $58.88 | $154.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $60.26 Median $208.93 Typical High $218.78 | Facility | None | $60.26 | $208.93 | $218.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $60.26 | Professional | None | $58.88 | $58.88 | $60.26 |
CareSource Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $107.15 Typical High $158.49 | Facility | None | $66.07 | $107.15 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $66.07 | Professional | None | $58.88 | $58.88 | $66.07 |
Kaiser Permanente Setting Professional Modifier None Typical Low $61.66 Median $79.43 Typical High $181.97 | Professional | None | $61.66 | $79.43 | $181.97 |
Oscar Health Setting Professional Modifier None Typical Low $60.26 Median $61.66 Typical High $69.18 | Professional | None | $60.26 | $61.66 | $69.18 |
United Setting Professional Modifier None Typical Low $60.26 Median $63.10 Typical High $87.10 | Professional | None | $60.26 | $63.10 | $87.10 |
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 $28.84 Median $28.84 Typical High $30.90 | Professional | 52 · Reduced service | $28.84 | $28.84 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $11.75 Typical High $12.30 | Professional | 53 · Discontinued | $11.75 | $11.75 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $8.71 Typical High $9.12 | Professional | 55 · Aftercare only | $8.71 | $8.71 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $5.89 Typical High $6.17 | Professional | 56 · Pre-op care only | $5.89 | $5.89 | $6.17 |
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· 51st of 51
$58.88
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.