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 $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $41.69 | Professional | None | $40.74 | $40.74 | $41.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $24.55 Median $46.77 Typical High $46.77 | Professional | None | $24.55 | $46.77 | $46.77 |
Cigna Setting Facility Modifier None Typical Low $25.70 Median $28.84 Typical High $46.77 | Facility | None | $25.70 | $28.84 | $46.77 |
Cigna Setting Professional Modifier None Typical Low $21.88 Median $25.70 Typical High $25.70 | Professional | None | $21.88 | $25.70 | $25.70 |
United Setting Professional Modifier None Typical Low $28.84 Median $70.79 Typical High $75.86 | Professional | None | $28.84 | $70.79 | $75.86 |
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 $19.95 Median $20.42 Typical High $20.89 | Professional | 52 · Reduced service | $19.95 | $20.42 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $8.13 Typical High $8.32 | Professional | 53 · Discontinued | $8.13 | $8.13 | $8.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.17 Typical High $6.31 | Professional | 55 · Aftercare only | $6.03 | $6.17 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.07 Typical High $4.17 | Professional | 56 · Pre-op care only | $4.07 | $4.07 | $4.17 |
Where Georgia sits
The same service costs 3.1 times more in Wisconsin than in New York. 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· 13th of 51
$46.77
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.