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 $3.47 Median $3.47 Typical High $3.98 | Facility | None | $3.47 | $3.47 | $3.98 |
Aetna Setting Professional Modifier None Typical Low $2.95 Median $3.47 Typical High $3.47 | Professional | None | $2.95 | $3.47 | $3.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.55 Median $3.98 Typical High $4.27 | Professional | None | $3.55 | $3.98 | $4.27 |
Cigna Setting Facility Modifier None Typical Low $3.72 Median $4.17 Typical High $6.61 | Facility | None | $3.72 | $4.17 | $6.61 |
Cigna Setting Professional Modifier None Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | None | $3.72 | $3.72 | $3.72 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4.68 Median $12.30 Typical High $33.11 | Professional | None | $4.68 | $12.30 | $33.11 |
United Setting Professional Modifier None Typical Low $1.74 Median $2.82 Typical High $8.71 | Professional | None | $1.74 | $2.82 | $8.71 |
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 $1.48 Median $1.74 Typical High $1.74 | Professional | 52 · Reduced service | $1.48 | $1.74 | $1.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.59 Median $0.69 Typical High $0.69 | Professional | 53 · Discontinued | $0.59 | $0.69 | $0.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.44 Median $0.52 Typical High $0.52 | Professional | 55 · Aftercare only | $0.44 | $0.52 | $0.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.30 Median $0.34 Typical High $0.34 | Professional | 56 · Pre-op care only | $0.30 | $0.34 | $0.34 |
Where Georgia sits
The same service costs 4.6 times more in Ohio than in Hawaii. 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
$3.98
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.