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 $25.70 Median $25.70 Typical High $26.92 | Facility | None | $25.70 | $25.70 | $26.92 |
Aetna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $27.54 | Professional | None | $25.70 | $25.70 | $27.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $23.99 Median $34.67 Typical High $63.10 | Professional | None | $23.99 | $34.67 | $63.10 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $28.18 Median $34.67 Typical High $79.43 | Professional | None | $28.18 | $34.67 | $79.43 |
Kaiser Permanente Setting Professional Modifier None Typical Low $27.54 Median $35.48 Typical High $120.23 | Professional | None | $27.54 | $35.48 | $120.23 |
Oscar Health Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $53.70 | Professional | None | $38.90 | $38.90 | $53.70 |
United Setting Professional Modifier None Typical Low $22.91 Median $35.48 Typical High $72.44 | Professional | None | $22.91 | $35.48 | $72.44 |
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 $12.88 Median $12.88 Typical High $13.80 | Professional | 52 · Reduced service | $12.88 | $12.88 | $13.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $5.13 Typical High $5.50 | Professional | 53 · Discontinued | $5.13 | $5.13 | $5.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $3.89 Typical High $4.07 | Professional | 55 · Aftercare only | $3.89 | $3.89 | $4.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $2.57 Typical High $2.75 | Professional | 56 · Pre-op care only | $2.57 | $2.57 | $2.75 |
Where Georgia sits
The same service costs 2.5 times more in Minnesota than in Arkansas. 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· 25th of 51
$34.67
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.