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 $3.16 Median $3.16 Typical High $8.71 | Facility | None | $3.16 | $3.16 | $8.71 |
Aetna Setting Professional Modifier None Typical Low $3.16 Median $4.07 Typical High $4.57 | Professional | None | $3.16 | $4.07 | $4.57 |
Ambetter Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $2.88 | Professional | None | $2.88 | $2.88 | $2.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $4.17 Median $6.31 Typical High $16.22 | Facility | None | $4.17 | $6.31 | $16.22 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.45 Median $2.45 Typical High $9.55 | Professional | None | $1.45 | $2.45 | $9.55 |
CareSource Setting Facility Modifier None Typical Low $3.02 Median $3.02 Typical High $3.02 | Facility | None | $3.02 | $3.02 | $3.02 |
CareSource Setting Professional Modifier None Typical Low $3.09 Median $4.68 Typical High $4.68 | Professional | None | $3.09 | $4.68 | $4.68 |
Cigna Setting Facility Modifier None Typical Low $4.68 Median $10.47 Typical High $26.30 | Facility | None | $4.68 | $10.47 | $26.30 |
Cigna Setting Professional Modifier None Typical Low $2.88 Median $5.75 Typical High $7.24 | Professional | None | $2.88 | $5.75 | $7.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $5.25 Median $7.08 Typical High $17.38 | Professional | None | $5.25 | $7.08 | $17.38 |
United Setting Facility Modifier None Typical Low $10.47 Median $10.47 Typical High $10.47 | Facility | None | $10.47 | $10.47 | $10.47 |
United Setting Professional Modifier None Typical Low $2.14 Median $3.47 Typical High $10.00 | Professional | None | $2.14 | $3.47 | $10.00 |
2 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 $1.58 Median $2.00 Typical High $2.29 | Professional | 52 · Reduced service | $1.58 | $2.00 | $2.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.63 Median $0.79 Typical High $0.91 | Professional | 53 · Discontinued | $0.63 | $0.79 | $0.91 |
Where Georgia sits
The same service costs 4.0 times more in Alaska than in Maryland. 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· 38th of 51
$4.17
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.