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 $16.60 Median $16.60 Typical High $18.62 | Facility | None | $16.60 | $16.60 | $18.62 |
Aetna Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $19.05 | Professional | None | $16.60 | $16.60 | $19.05 |
Anthem BCBS Setting Professional Modifier None Typical Low $16.60 Median $21.88 Typical High $34.67 | Professional | None | $16.60 | $21.88 | $34.67 |
CareSource Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | None | $15.85 | $15.85 | $15.85 |
Cigna Setting Professional Modifier None Typical Low $18.20 Median $25.70 Typical High $51.29 | Professional | None | $18.20 | $25.70 | $51.29 |
Kaiser Permanente Setting Professional Modifier None Typical Low $20.42 Median $25.12 Typical High $114.82 | Professional | None | $20.42 | $25.12 | $114.82 |
Oscar Health Setting Professional Modifier None Typical Low $19.05 Median $30.90 Typical High $42.66 | Professional | None | $19.05 | $30.90 | $42.66 |
United Setting Professional Modifier None Typical Low $17.38 Median $28.18 Typical High $51.29 | Professional | None | $17.38 | $28.18 | $51.29 |
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 $8.13 Median $8.13 Typical High $9.55 | Professional | 52 · Reduced service | $8.13 | $8.13 | $9.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.31 Median $3.31 Typical High $3.80 | Professional | 53 · Discontinued | $3.31 | $3.31 | $3.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.45 Median $2.45 Typical High $2.88 | Professional | 55 · Aftercare only | $2.45 | $2.45 | $2.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.62 Median $1.62 Typical High $1.91 | Professional | 56 · Pre-op care only | $1.62 | $1.62 | $1.91 |
Where Georgia sits
The same service costs 3.4 times more in Alaska than in Florida. 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· 19th of 51
$21.88
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.