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 $12.88 Median $12.88 Typical High $13.80 | Facility | None | $12.88 | $12.88 | $13.80 |
Aetna Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $28.18 | Professional | None | $12.88 | $12.88 | $28.18 |
Ambetter Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $63.10 | Professional | None | $29.51 | $29.51 | $63.10 |
Anthem BCBS Setting Facility Modifier None Typical Low $12.88 Median $29.51 Typical High $70.79 | Facility | None | $12.88 | $29.51 | $70.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $12.88 Median $14.13 Typical High $16.98 | Professional | None | $12.88 | $14.13 | $16.98 |
Cigna Setting Facility Modifier None Typical Low $13.18 Median $15.14 Typical High $23.99 | Facility | None | $13.18 | $15.14 | $23.99 |
Cigna Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $13.18 | Professional | None | $13.18 | $13.18 | $13.18 |
Kaiser Permanente Setting Professional Modifier None Typical Low $13.18 Median $87.10 Typical High $112.20 | Professional | None | $13.18 | $87.10 | $112.20 |
United Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $18.20 | Professional | None | $12.88 | $12.88 | $18.20 |
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 $6.46 Median $6.46 Typical High $6.46 | Professional | 52 · Reduced service | $6.46 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.57 Median $2.57 Typical High $2.57 | Professional | 53 · Discontinued | $2.57 | $2.57 | $2.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.91 Median $1.95 Typical High $1.95 | Professional | 55 · Aftercare only | $1.91 | $1.95 | $1.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.29 Median $1.29 Typical High $1.29 | Professional | 56 · Pre-op care only | $1.29 | $1.29 | $1.29 |
Where Georgia sits
The same service costs 11.0 times more in Kansas 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· 25th of 51
$14.13
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.