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 $93.33 Median $93.33 Typical High $95.50 | Facility | None | $93.33 | $93.33 | $95.50 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $97.72 Typical High $128.82 | Professional | None | $93.33 | $97.72 | $128.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $100.00 Median $120.23 Typical High $158.49 | Professional | None | $100.00 | $120.23 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $281.84 | Professional | None | $102.33 | $102.33 | $281.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $77.62 Median $104.71 Typical High $218.78 | Professional | None | $77.62 | $104.71 | $218.78 |
United Setting Professional Modifier None Typical Low $83.18 Median $123.03 Typical High $309.03 | Professional | None | $83.18 | $123.03 | $309.03 |
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 $46.77 Median $46.77 Typical High $54.95 | Professional | 52 · Reduced service | $46.77 | $46.77 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $18.62 Typical High $21.88 | Professional | 53 · Discontinued | $18.62 | $18.62 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $14.13 Typical High $16.22 | Professional | 55 · Aftercare only | $13.80 | $14.13 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $9.33 Typical High $10.96 | Professional | 56 · Pre-op care only | $9.33 | $9.33 | $10.96 |
Where Georgia sits
The same service costs 3.0 times more in Alaska than in West Virginia. 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· 19th of 51
$120
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.