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 $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $102.33 | Professional | None | $100.00 | $100.00 | $102.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $91.20 Median $114.82 Typical High $147.91 | Professional | None | $91.20 | $114.82 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $234.42 Typical High $338.84 | Facility | None | $144.54 | $234.42 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $144.54 | Professional | None | $125.89 | $125.89 | $144.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $114.82 Median $128.82 Typical High $154.88 | Professional | None | $114.82 | $128.82 | $154.88 |
Oscar Health Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $239.88 | Professional | None | $194.98 | $194.98 | $239.88 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $173.78 | Professional | None | $125.89 | $125.89 | $173.78 |
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 $50.12 Median $50.12 Typical High $51.29 | Professional | 52 · Reduced service | $50.12 | $50.12 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $19.95 Typical High $20.42 | Professional | 53 · Discontinued | $19.95 | $19.95 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.14 Typical High $15.49 | Professional | 55 · Aftercare only | $15.14 | $15.14 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.00 Typical High $10.23 | Professional | 56 · Pre-op care only | $10.00 | $10.00 | $10.23 |
Where Georgia sits
The same service costs 1.9 times more in North Dakota than in Hawaii. 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· 31st of 51
$120
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.