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 $41.69 Median $41.69 Typical High $51.29 | Facility | None | $41.69 | $41.69 | $51.29 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $67.61 | Professional | None | $41.69 | $41.69 | $67.61 |
Anthem BCBS Setting Facility Modifier None Typical Low $50.12 Median $173.78 Typical High $181.97 | Facility | None | $50.12 | $173.78 | $181.97 |
Anthem BCBS Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $169.82 | Professional | None | $41.69 | $41.69 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $75.86 Typical High $112.20 | Facility | None | $57.54 | $75.86 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | None | $41.69 | $41.69 | $41.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $63.10 Median $199.53 Typical High $288.40 | Professional | None | $63.10 | $199.53 | $288.40 |
United Setting Professional Modifier None Typical Low $50.12 Median $52.48 Typical High $75.86 | Professional | None | $50.12 | $52.48 | $75.86 |
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 $20.89 Median $20.89 Typical High $33.88 | Professional | 52 · Reduced service | $20.89 | $20.89 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $8.32 Typical High $13.49 | Professional | 53 · Discontinued | $8.32 | $8.32 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $6.17 Typical High $10.00 | Professional | 55 · Aftercare only | $6.17 | $6.17 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.17 Typical High $6.76 | Professional | 56 · Pre-op care only | $4.17 | $4.17 | $6.76 |
Where Georgia sits
The same service costs 24.5 times more in Alabama than in Georgia. 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· 51st of 51
$41.69
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.