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 $21.88 Median $21.88 Typical High $21.88 | Facility | None | $21.88 | $21.88 | $21.88 |
Aetna Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $30.20 | Professional | None | $21.88 | $21.88 | $30.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $21.88 Median $35.48 Typical High $81.28 | Facility | None | $21.88 | $35.48 | $81.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $12.59 Median $19.95 Typical High $21.88 | Professional | None | $12.59 | $19.95 | $21.88 |
Cigna Setting Facility Modifier None Typical Low $21.88 Median $24.55 Typical High $38.90 | Facility | None | $21.88 | $24.55 | $38.90 |
Cigna Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $13.80 Median $16.98 Typical High $25.12 | Professional | None | $13.80 | $16.98 | $25.12 |
United Setting Professional Modifier None Typical Low $22.39 Median $23.99 Typical High $46.77 | Professional | None | $22.39 | $23.99 | $46.77 |
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 $10.96 Median $10.96 Typical High $11.75 | Professional | 52 · Reduced service | $10.96 | $10.96 | $11.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.37 Median $4.37 Typical High $4.68 | Professional | 53 · Discontinued | $4.37 | $4.37 | $4.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.31 Median $3.31 Typical High $3.47 | Professional | 55 · Aftercare only | $3.31 | $3.31 | $3.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $2.19 Typical High $2.29 | Professional | 56 · Pre-op care only | $2.19 | $2.19 | $2.29 |
Where Georgia sits
The same service costs 1.9 times more in Alabama than in Georgia. 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· 51st of 51
$19.95
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.