How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $52.48 Median $57.54 Typical High $57.54 | Facility | None | $52.48 | $57.54 | $57.54 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $57.54 Typical High $57.54 | Professional | None | $52.48 | $57.54 | $57.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $56.23 Median $60.26 Typical High $83.18 | Professional | None | $56.23 | $60.26 | $83.18 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $43.65 Median $66.07 Typical High $79.43 | Professional | None | $43.65 | $66.07 | $79.43 |
Oscar Health Setting Professional Modifier None Typical Low $70.79 Median $151.36 Typical High $181.97 | Professional | None | $70.79 | $151.36 | $181.97 |
United Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $85.11 | Professional | None | $61.66 | $61.66 | $85.11 |
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 $26.30 Median $28.84 Typical High $28.84 | Professional | 52 · Reduced service | $26.30 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $11.48 Typical High $11.48 | Professional | 53 · Discontinued | $10.47 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $8.71 Typical High $8.71 | Professional | 55 · Aftercare only | $7.76 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.75 Typical High $5.75 | Professional | 56 · Pre-op care only | $5.25 | $5.75 | $5.75 |
Where Georgia sits
The same service costs 4.6 times more in New York than in North Carolina. 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· 39th of 51
$60.26
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.