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 $10.47 Median $10.47 Typical High $11.75 | Facility | None | $10.47 | $10.47 | $11.75 |
Aetna Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $12.02 | Professional | None | $10.47 | $10.47 | $12.02 |
Ambetter Setting Professional Modifier None Typical Low $11.48 Median $21.38 Typical High $26.30 | Professional | None | $11.48 | $21.38 | $26.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $7.76 Median $11.48 Typical High $23.99 | Professional | None | $7.76 | $11.48 | $23.99 |
CareSource Setting Professional Modifier None Typical Low $10.47 Median $14.45 Typical High $16.60 | Professional | None | $10.47 | $14.45 | $16.60 |
Cigna Setting Professional Modifier None Typical Low $10.96 Median $15.49 Typical High $34.67 | Professional | None | $10.96 | $15.49 | $34.67 |
Kaiser Permanente Setting Professional Modifier None Typical Low $12.59 Median $14.45 Typical High $30.90 | Professional | None | $12.59 | $14.45 | $30.90 |
United Setting Professional Modifier None Typical Low $11.48 Median $17.38 Typical High $34.67 | Professional | None | $11.48 | $17.38 | $34.67 |
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 $5.25 Median $5.25 Typical High $6.03 | Professional | 52 · Reduced service | $5.25 | $5.25 | $6.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.09 Median $2.09 Typical High $2.40 | Professional | 53 · Discontinued | $2.09 | $2.09 | $2.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.58 Median $1.58 Typical High $1.82 | Professional | 55 · Aftercare only | $1.58 | $1.58 | $1.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.05 Median $1.05 Typical High $1.20 | Professional | 56 · Pre-op care only | $1.05 | $1.05 | $1.20 |
Where Georgia sits
The same service costs 2.6 times more in Alaska than in Kentucky. 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· 39th of 51
$11.22
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.