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 $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $72.44 | Professional | None | $53.70 | $53.70 | $72.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $53.70 Median $120.23 Typical High $295.12 | Facility | None | $53.70 | $120.23 | $295.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $13.18 Median $53.70 Typical High $53.70 | Professional | None | $13.18 | $53.70 | $53.70 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $100.00 Typical High $144.54 | Facility | None | $60.26 | $100.00 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
Kaiser Permanente Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $57.54 | Professional | None | $9.33 | $9.33 | $57.54 |
United Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $67.61 | Professional | None | $51.29 | $51.29 | $67.61 |
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 $26.92 Median $26.92 Typical High $28.18 | Professional | 52 · Reduced service | $26.92 | $26.92 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $10.72 Typical High $11.22 | Professional | 53 · Discontinued | $10.72 | $10.72 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.13 Typical High $8.51 | Professional | 55 · Aftercare only | $8.13 | $8.13 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.37 Typical High $5.62 | Professional | 56 · Pre-op care only | $5.37 | $5.37 | $5.62 |
Where Georgia sits
The same service costs 3.0 times more in Arizona than in Oklahoma. 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· 28th of 51
$53.70
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.