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 $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $128.82 | Professional | None | $75.86 | $75.86 | $128.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $75.86 Median $89.13 Typical High $380.19 | Facility | None | $75.86 | $89.13 | $380.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $58.88 Median $85.11 Typical High $85.11 | Professional | None | $58.88 | $85.11 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $138.04 Typical High $204.17 | Facility | None | $85.11 | $138.04 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $64.57 Median $81.28 Typical High $87.10 | Professional | None | $64.57 | $81.28 | $87.10 |
United Setting Professional Modifier None Typical Low $85.11 Median $100.00 Typical High $194.98 | Professional | None | $85.11 | $100.00 | $194.98 |
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 $38.02 Median $38.02 Typical High $50.12 | Professional | 52 · Reduced service | $38.02 | $38.02 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $15.14 Typical High $19.95 | Professional | 53 · Discontinued | $15.14 | $15.14 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $11.48 Typical High $14.79 | Professional | 55 · Aftercare only | $11.48 | $11.48 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $10.00 | Professional | 56 · Pre-op care only | $7.59 | $7.59 | $10.00 |
Where Georgia sits
The same service costs 2.9 times more in Arizona than in Alabama. 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· 40th of 51
$85.11
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.