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 $6.92 Median $6.92 Typical High $7.24 | Facility | None | $6.92 | $6.92 | $7.24 |
Aetna Setting Professional Modifier None Typical Low $6.92 Median $7.24 Typical High $44.67 | Professional | None | $6.92 | $7.24 | $44.67 |
Anthem BCBS Setting Professional Modifier None Typical Low $7.24 Median $20.42 Typical High $31.62 | Professional | None | $7.24 | $20.42 | $31.62 |
Cigna Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | None | $20.89 | $20.89 | $20.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $21.88 Median $22.39 Typical High $37.15 | Professional | None | $21.88 | $22.39 | $37.15 |
Oscar Health Setting Facility Modifier None Typical Low $295.12 Median $354.81 Typical High $354.81 | Facility | None | $295.12 | $354.81 | $354.81 |
United Setting Professional Modifier None Typical Low $14.45 Median $25.70 Typical High $91.20 | Professional | None | $14.45 | $25.70 | $91.20 |
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 $3.47 Median $3.47 Typical High $3.63 | Professional | 52 · Reduced service | $3.47 | $3.47 | $3.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.38 Median $1.38 Typical High $1.45 | Professional | 53 · Discontinued | $1.38 | $1.38 | $1.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.02 Median $1.02 Typical High $1.10 | Professional | 55 · Aftercare only | $1.02 | $1.02 | $1.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.69 Median $0.69 Typical High $0.72 | Professional | 56 · Pre-op care only | $0.69 | $0.69 | $0.72 |
Where Georgia sits
The same service costs 6.6 times more in Alabama than in Kansas. 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· 42nd of 51
$20.42
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.