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 $2.95 Median $2.95 Typical High $4.47 | Facility | None | $2.95 | $2.95 | $4.47 |
Aetna Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $5.75 | Professional | None | $2.95 | $2.95 | $5.75 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.95 Median $5.25 Typical High $16.22 | Facility | None | $2.95 | $5.25 | $16.22 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.34 Median $2.95 Typical High $3.63 | Professional | None | $2.34 | $2.95 | $3.63 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3.31 Median $4.27 Typical High $4.27 | Professional | None | $3.31 | $4.27 | $4.27 |
United Setting Professional Modifier None Typical Low $3.63 Median $3.63 Typical High $5.01 | Professional | None | $3.63 | $3.63 | $5.01 |
5 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 $1.48 Median $1.48 Typical High $2.40 | Professional | 52 · Reduced service | $1.48 | $1.48 | $2.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.59 Median $0.59 Typical High $0.98 | Professional | 53 · Discontinued | $0.59 | $0.59 | $0.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.44 Median $0.44 Typical High $0.72 | Professional | 55 · Aftercare only | $0.44 | $0.44 | $0.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.28 Typical High $0.48 | Professional | 56 · Pre-op care only | $0.28 | $0.28 | $0.48 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $4.68 Median $4.68 Typical High $4.68 | Professional | JZ · No drug discarded | $4.68 | $4.68 | $4.68 |
Where Georgia sits
The same service costs 2.8 times more in Wyoming than in Florida. 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· 50th of 51
$2.95
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.