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 $10.47 Median $10.47 Typical High $10.47 | Facility | None | $10.47 | $10.47 | $10.47 |
Aetna Setting Professional Modifier None Typical Low $10.23 Median $10.47 Typical High $10.96 | Professional | None | $10.23 | $10.47 | $10.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $10.47 Median $23.99 Typical High $57.54 | Facility | None | $10.47 | $23.99 | $57.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.32 Median $10.47 Typical High $12.02 | Professional | None | $8.32 | $10.47 | $12.02 |
Cigna Setting Facility Modifier None Typical Low $10.72 Median $12.02 Typical High $19.50 | Facility | None | $10.72 | $12.02 | $19.50 |
Cigna Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | None | $10.72 | $10.72 | $10.72 |
Kaiser Permanente Setting Professional Modifier None Typical Low $9.12 Median $10.72 Typical High $26.92 | Professional | None | $9.12 | $10.72 | $26.92 |
United Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $16.22 | Professional | None | $10.47 | $10.47 | $16.22 |
2 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 55 · Aftercare only Typical Low $1.55 Median $1.58 Typical High $1.66 | Professional | 55 · Aftercare only | $1.55 | $1.58 | $1.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.02 Median $1.05 Typical High $1.10 | Professional | 56 · Pre-op care only | $1.02 | $1.05 | $1.10 |
Where Georgia sits
The same service costs 1.7 times more in Arizona 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· 48th of 51
$10.47
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.