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 $13.18 Median $13.18 Typical High $14.13 | Facility | None | $13.18 | $13.18 | $14.13 |
Aetna Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $15.14 | Professional | None | $13.18 | $13.18 | $15.14 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.46 Median $9.55 Typical High $34.67 | Professional | None | $6.46 | $9.55 | $34.67 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | None | $12.02 | $12.02 | $12.02 |
Kaiser Permanente Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $21.88 | Professional | None | $15.14 | $15.14 | $21.88 |
United Setting Professional Modifier None Typical Low $12.88 Median $20.42 Typical High $38.02 | Professional | None | $12.88 | $20.42 | $38.02 |
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 $6.61 Median $6.61 Typical High $7.59 | Professional | 52 · Reduced service | $6.61 | $6.61 | $7.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.63 Median $2.63 Typical High $3.02 | Professional | 53 · Discontinued | $2.63 | $2.63 | $3.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.00 Median $2.00 Typical High $2.29 | Professional | 55 · Aftercare only | $2.00 | $2.00 | $2.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.32 Median $1.32 Typical High $1.51 | Professional | 56 · Pre-op care only | $1.32 | $1.32 | $1.51 |
Where Georgia sits
The same service costs 4.9 times more in Alaska than in Connecticut. 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· 41st of 51
$13.80
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.