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 $5.62 Median $5.62 Typical High $5.62 | Facility | None | $5.62 | $5.62 | $5.62 |
Aetna Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $6.92 | Professional | None | $5.62 | $5.62 | $6.92 |
Anthem BCBS Setting Facility Modifier None Typical Low $5.62 Median $19.50 Typical High $20.89 | Facility | None | $5.62 | $19.50 | $20.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.27 Median $5.62 Typical High $5.62 | Professional | None | $4.27 | $5.62 | $5.62 |
Cigna Setting Facility Modifier None Typical Low $6.31 Median $10.23 Typical High $15.14 | Facility | None | $6.31 | $10.23 | $15.14 |
Cigna Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | None | $5.62 | $5.62 | $5.62 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4.90 Median $19.05 Typical High $30.90 | Professional | None | $4.90 | $19.05 | $30.90 |
United Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $8.51 | Professional | None | $5.62 | $5.62 | $8.51 |
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 $2.82 Median $2.82 Typical High $3.47 | Professional | 52 · Reduced service | $2.82 | $2.82 | $3.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.12 Median $1.12 Typical High $1.38 | Professional | 53 · Discontinued | $1.12 | $1.12 | $1.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.83 Median $0.83 Typical High $0.89 | Professional | 55 · Aftercare only | $0.83 | $0.83 | $0.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.56 Median $0.56 Typical High $0.59 | Professional | 56 · Pre-op care only | $0.56 | $0.56 | $0.59 |
Where Georgia sits
The same service costs 1.7 times more in Arizona than in Vermont. 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
$5.62
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.