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 $18.20 Median $18.20 Typical High $19.50 | Facility | None | $18.20 | $18.20 | $19.50 |
Aetna Setting Professional Modifier None Typical Low $18.20 Median $19.05 Typical High $20.89 | Professional | None | $18.20 | $19.05 | $20.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $18.20 Median $27.54 Typical High $38.02 | Professional | None | $18.20 | $27.54 | $38.02 |
Cigna Setting Professional Modifier None Typical Low $19.50 Median $24.55 Typical High $37.15 | Professional | None | $19.50 | $24.55 | $37.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
United Setting Professional Modifier None Typical Low $19.95 Median $36.31 Typical High $57.54 | Professional | None | $19.95 | $36.31 | $57.54 |
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 $8.91 Median $9.55 Typical High $10.47 | Professional | 52 · Reduced service | $8.91 | $9.55 | $10.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $3.80 Typical High $4.17 | Professional | 53 · Discontinued | $3.63 | $3.80 | $4.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.69 Median $2.82 Typical High $3.16 | Professional | 55 · Aftercare only | $2.69 | $2.82 | $3.16 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $1.91 Typical High $2.09 | Professional | 56 · Pre-op care only | $1.82 | $1.91 | $2.09 |
Where Georgia sits
The same service costs 4.3 times more in Alaska than in New York. 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· 24th of 51
$27.54
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.