How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $0.39 Median $0.39 Typical High $0.87 | Facility | None | $0.39 | $0.39 | $0.87 |
Aetna Setting Professional Modifier None Typical Low $0.39 Median $0.39 Typical High $0.65 | Professional | None | $0.39 | $0.39 | $0.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.39 Median $0.87 Typical High $2.14 | Facility | None | $0.39 | $0.87 | $2.14 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.39 Median $0.39 Typical High $0.65 | Professional | None | $0.39 | $0.39 | $0.65 |
Cigna Setting Facility Modifier None Typical Low $0.44 Median $0.72 Typical High $1.05 | Facility | None | $0.44 | $0.72 | $1.05 |
Cigna Setting Professional Modifier None Typical Low $0.39 Median $0.39 Typical High $0.39 | Professional | None | $0.39 | $0.39 | $0.39 |
Kaiser Permanente Setting Professional Modifier None Typical Low $0.58 Median $5.01 Typical High $8.91 | Professional | None | $0.58 | $5.01 | $8.91 |
United Setting Professional Modifier None Typical Low $0.48 Median $0.48 Typical High $0.83 | Professional | None | $0.48 | $0.48 | $0.83 |
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 $0.20 Median $0.20 Typical High $0.32 | Professional | 52 · Reduced service | $0.20 | $0.20 | $0.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.08 Median $0.08 Typical High $0.13 | Professional | 53 · Discontinued | $0.08 | $0.08 | $0.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.06 Median $0.06 Typical High $0.10 | Professional | 55 · Aftercare only | $0.06 | $0.06 | $0.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.06 |
Where Georgia sits
The same service costs 5.2 times more in Wyoming than in Georgia. 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· 51st of 51
$0.39
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.