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 $5.89 Median $5.89 Typical High $5.89 | Facility | None | $5.89 | $5.89 | $5.89 |
Aetna Setting Professional Modifier None Typical Low $5.75 Median $5.89 Typical High $5.89 | Professional | None | $5.75 | $5.89 | $5.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.02 Median $0.05 Typical High $0.05 | Facility | None | $0.02 | $0.05 | $0.05 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.37 Median $6.76 Typical High $11.48 | Professional | None | $5.37 | $6.76 | $11.48 |
Cigna Setting Facility Modifier None Typical Low $6.17 Median $6.92 Typical High $11.22 | Facility | None | $6.17 | $6.92 | $11.22 |
Cigna Setting Professional Modifier None Typical Low $6.17 Median $6.17 Typical High $6.17 | Professional | None | $6.17 | $6.17 | $6.17 |
Kaiser Permanente Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $6.03 | Professional | None | $5.50 | $5.50 | $6.03 |
United Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $15.49 | Professional | None | $12.30 | $12.30 | $15.49 |
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 $2.88 Median $2.95 Typical High $2.95 | Professional | 52 · Reduced service | $2.88 | $2.95 | $2.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.15 Median $1.17 Typical High $1.17 | Professional | 53 · Discontinued | $1.15 | $1.17 | $1.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.87 Median $0.87 Typical High $0.87 | Professional | 55 · Aftercare only | $0.87 | $0.87 | $0.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.58 Median $0.58 Typical High $0.58 | Professional | 56 · Pre-op care only | $0.58 | $0.58 | $0.58 |
Where Georgia sits
The same service costs 2.1 times more in Iowa than in Montana. 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· 29th of 51
$6.76
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.