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 $147.91 Median $147.91 Typical High $147.91 | Facility | None | $147.91 | $147.91 | $147.91 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $416.87 | Professional | None | $147.91 | $147.91 | $416.87 |
Ambetter Setting Professional Modifier None Typical Low $147.91 Median $257.04 Typical High $257.04 | Professional | None | $147.91 | $257.04 | $257.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $134.90 Median $416.87 Typical High $501.19 | Facility | None | $134.90 | $416.87 | $501.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $134.90 Median $147.91 Typical High $177.83 | Professional | None | $134.90 | $147.91 | $177.83 |
CareSource Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $169.82 | Professional | None | $107.15 | $107.15 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $275.42 Typical High $398.11 | Facility | None | $169.82 | $275.42 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $169.82 | Professional | None | $147.91 | $147.91 | $169.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $302.00 | Professional | None | $162.18 | $162.18 | $302.00 |
Oscar Health Setting Professional Modifier None Typical Low $134.90 Median $162.18 Typical High $181.97 | Professional | None | $134.90 | $162.18 | $181.97 |
United Setting Professional Modifier None Typical Low $134.90 Median $144.54 Typical High $194.98 | Professional | None | $134.90 | $144.54 | $194.98 |
5 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 $74.13 Median $74.13 Typical High $74.13 | Professional | 52 · Reduced service | $74.13 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | 53 · Discontinued | $29.51 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | 55 · Aftercare only | $22.39 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | 56 · Pre-op care only | $14.79 | $14.79 | $14.79 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $141.25 Median $194.98 Typical High $194.98 | Professional | JZ · No drug discarded | $141.25 | $194.98 | $194.98 |
Where Georgia sits
The same service costs 2.4 times more in Wyoming than in New York. 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· 48th of 51
$148
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.