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 $5.01 Median $10.00 Typical High $10.00 | Facility | None | $5.01 | $10.00 | $10.00 |
Aetna Setting Professional Modifier None Typical Low $5.01 Median $10.00 Typical High $38.90 | Professional | None | $5.01 | $10.00 | $38.90 |
Ambetter Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | None | $13.80 | $13.80 | $13.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.13 Median $15.14 Typical High $33.11 | Professional | None | $5.13 | $15.14 | $33.11 |
Cigna Setting Professional Modifier None Typical Low $7.94 Median $12.88 Typical High $22.39 | Professional | None | $7.94 | $12.88 | $22.39 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4.47 Median $17.78 Typical High $19.50 | Professional | None | $4.47 | $17.78 | $19.50 |
United Setting Professional Modifier None Typical Low $10.47 Median $16.60 Typical High $43.65 | Professional | None | $10.47 | $16.60 | $43.65 |
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 $2.51 Median $5.01 Typical High $5.01 | Professional | 52 · Reduced service | $2.51 | $5.01 | $5.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.00 Median $2.00 Typical High $2.00 | Professional | 53 · Discontinued | $1.00 | $2.00 | $2.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.76 Median $1.51 Typical High $1.51 | Professional | 55 · Aftercare only | $0.76 | $1.51 | $1.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.50 Median $1.00 Typical High $1.00 | Professional | 56 · Pre-op care only | $0.50 | $1.00 | $1.00 |
Anthem BCBS Setting Professional Modifier EP · Child screening program Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | EP · Child screening program | $10.00 | $10.00 | $10.00 |
Where Georgia sits
The same service costs 5.2 times more in Texas than in Kentucky. 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· 47th of 51
$14.45
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.