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 $0.79 Median $0.79 Typical High $1.32 | Facility | None | $0.79 | $0.79 | $1.32 |
Aetna Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $1.55 | Professional | None | $0.79 | $0.79 | $1.55 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.79 Median $1.82 Typical High $4.37 | Facility | None | $0.79 | $1.82 | $4.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.68 Median $0.79 Typical High $1.00 | Professional | None | $0.68 | $0.79 | $1.00 |
Cigna Setting Facility Modifier None Typical Low $0.89 Median $1.45 Typical High $2.14 | Facility | None | $0.89 | $1.45 | $2.14 |
Cigna Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $0.79 | Professional | None | $0.79 | $0.79 | $0.79 |
Kaiser Permanente Setting Professional Modifier None Typical Low $0.81 Median $0.91 Typical High $3.09 | Professional | None | $0.81 | $0.91 | $3.09 |
United Setting Professional Modifier None Typical Low $0.85 Median $0.85 Typical High $1.48 | Professional | None | $0.85 | $0.85 | $1.48 |
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 $0.40 Median $0.40 Typical High $0.44 | Professional | 52 · Reduced service | $0.40 | $0.40 | $0.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.16 Median $0.16 Typical High $0.18 | Professional | 53 · Discontinued | $0.16 | $0.16 | $0.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.12 Median $0.12 Typical High $0.13 | Professional | 55 · Aftercare only | $0.12 | $0.12 | $0.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.08 Median $0.08 Typical High $0.09 | Professional | 56 · Pre-op care only | $0.08 | $0.08 | $0.09 |
Where Georgia sits
The same service costs 2.3 times more in Alaska than in Alabama. 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· 49th of 51
$0.79
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.