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 $51.29 Median $51.29 Typical High $51.29 | Facility | None | $51.29 | $51.29 | $51.29 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $67.61 | Professional | None | $51.29 | $51.29 | $67.61 |
Ambetter Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $47.86 Median $56.23 Typical High $239.88 | Facility | None | $47.86 | $56.23 | $239.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $28.18 Median $48.98 Typical High $48.98 | Professional | None | $28.18 | $48.98 | $48.98 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $60.26 Typical High $95.50 | Facility | None | $53.70 | $60.26 | $95.50 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3.31 Median $25.70 Typical High $33.11 | Professional | None | $3.31 | $25.70 | $33.11 |
United Setting Professional Modifier None Typical Low $46.77 Median $57.54 Typical High $112.20 | Professional | None | $46.77 | $57.54 | $112.20 |
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 $25.70 Median $25.70 Typical High $25.70 | Professional | 52 · Reduced service | $25.70 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | 53 · Discontinued | $10.23 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | 55 · Aftercare only | $7.59 | $7.59 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | 56 · Pre-op care only | $5.13 | $5.13 | $5.13 |
Where Georgia sits
The same service costs 1.5 times more in Colorado than in Alaska. 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· 43rd of 51
$48.98
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.