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 $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $57.54 | Professional | None | $43.65 | $43.65 | $57.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $42.66 Median $147.91 Typical High $158.49 | Facility | None | $42.66 | $147.91 | $158.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $34.67 Median $43.65 Typical High $44.67 | Professional | None | $34.67 | $43.65 | $44.67 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $79.43 Typical High $117.49 | Facility | None | $48.98 | $79.43 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $46.77 Median $77.62 Typical High $89.13 | Professional | None | $46.77 | $77.62 | $89.13 |
United Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $54.95 | Professional | None | $42.66 | $42.66 | $54.95 |
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 $21.88 Median $21.88 Typical High $25.12 | Professional | 52 · Reduced service | $21.88 | $21.88 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $8.71 Typical High $10.00 | Professional | 53 · Discontinued | $8.71 | $8.71 | $10.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.46 Typical High $7.59 | Professional | 55 · Aftercare only | $6.46 | $6.46 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.37 Typical High $5.01 | Professional | 56 · Pre-op care only | $4.37 | $4.37 | $5.01 |
Where Georgia sits
The same service costs 1.6 times more in Arizona than in Maryland. 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· 31st of 51
$43.65
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.