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 $3.89 Median $3.89 Typical High $3.89 | Facility | None | $3.89 | $3.89 | $3.89 |
Aetna Setting Professional Modifier None Typical Low $3.89 Median $3.89 Typical High $3.98 | Professional | None | $3.89 | $3.89 | $3.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.80 Median $5.50 Typical High $7.08 | Professional | None | $3.80 | $5.50 | $7.08 |
Cigna Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $5.75 | Professional | None | $3.98 | $3.98 | $5.75 |
Kaiser Permanente Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $32.36 | Professional | None | $19.05 | $19.05 | $32.36 |
United Setting Professional Modifier None Typical Low $2.34 Median $5.89 Typical High $6.46 | Professional | None | $2.34 | $5.89 | $6.46 |
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 $1.95 Median $1.95 Typical High $2.00 | Professional | 52 · Reduced service | $1.95 | $1.95 | $2.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.78 Median $0.78 Typical High $0.79 | Professional | 53 · Discontinued | $0.78 | $0.78 | $0.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.58 Median $0.59 Typical High $0.60 | Professional | 55 · Aftercare only | $0.58 | $0.59 | $0.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.39 Median $0.39 Typical High $0.40 | Professional | 56 · Pre-op care only | $0.39 | $0.39 | $0.40 |
Where Georgia sits
The same service costs 5.9 times more in Hawaii than in Arkansas. 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· 14th of 51
$5.50
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.