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 $33.11 Median $33.11 Typical High $33.11 | Facility | None | $33.11 | $33.11 | $33.11 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $63.10 | Professional | None | $33.11 | $33.11 | $63.10 |
Ambetter Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $30.90 Median $95.50 Typical High $114.82 | Facility | None | $30.90 | $95.50 | $114.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $24.55 Median $33.11 Typical High $33.88 | Professional | None | $24.55 | $33.11 | $33.88 |
CareSource Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $47.86 | Professional | None | $30.20 | $30.20 | $47.86 |
Cigna Setting Facility Modifier None Typical Low $37.15 Median $60.26 Typical High $89.13 | Facility | None | $37.15 | $60.26 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $38.90 | Professional | None | $33.11 | $33.11 | $38.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $31.62 Median $40.74 Typical High $60.26 | Professional | None | $31.62 | $40.74 | $60.26 |
Oscar Health Setting Professional Modifier None Typical Low $30.90 Median $31.62 Typical High $35.48 | Professional | None | $30.90 | $31.62 | $35.48 |
United Setting Professional Modifier None Typical Low $30.90 Median $33.11 Typical High $43.65 | Professional | None | $30.90 | $33.11 | $43.65 |
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 $16.60 Median $16.60 Typical High $17.38 | Professional | 52 · Reduced service | $16.60 | $16.60 | $17.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $6.61 Typical High $6.92 | Professional | 53 · Discontinued | $6.61 | $6.61 | $6.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $4.90 Typical High $5.13 | Professional | 55 · Aftercare only | $4.90 | $4.90 | $5.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $3.31 Typical High $3.47 | Professional | 56 · Pre-op care only | $3.31 | $3.31 | $3.47 |
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· 21st of 51
$33.11
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.