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 $13.80 Median $13.80 Typical High $13.80 | Facility | None | $13.80 | $13.80 | $13.80 |
Aetna Setting Professional Modifier None Typical Low $13.49 Median $13.80 Typical High $13.80 | Professional | None | $13.49 | $13.80 | $13.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.95 Median $15.14 Typical High $17.78 | Professional | None | $0.95 | $15.14 | $17.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $102.33 | Professional | None | $79.43 | $79.43 | $102.33 |
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 $6.76 Median $6.92 Typical High $6.92 | Professional | 52 · Reduced service | $6.76 | $6.92 | $6.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.75 Median $2.75 Typical High $2.75 | Professional | 53 · Discontinued | $2.75 | $2.75 | $2.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.04 Median $2.04 Typical High $2.04 | Professional | 55 · Aftercare only | $2.04 | $2.04 | $2.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.35 Median $1.38 Typical High $1.38 | Professional | 56 · Pre-op care only | $1.35 | $1.38 | $1.38 |
Where Georgia sits
The same service costs 1412.5 times more in Wyoming than in Missouri. 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· 11th of 51
$14.45
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.