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 $12.88 Median $12.88 Typical High $12.88 | Facility | None | $12.88 | $12.88 | $12.88 |
Aetna Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $19.50 | Professional | None | $12.88 | $12.88 | $19.50 |
Anthem BCBS Setting Facility Modifier None Typical Low $12.59 Median $43.65 Typical High $46.77 | Facility | None | $12.59 | $43.65 | $46.77 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.23 Median $12.88 Typical High $13.80 | Professional | None | $10.23 | $12.88 | $13.80 |
Cigna Setting Facility Modifier None Typical Low $14.45 Median $23.99 Typical High $34.67 | Facility | None | $14.45 | $23.99 | $34.67 |
Cigna Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $12.88 | Professional | None | $12.88 | $12.88 | $12.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $13.80 Median $30.20 Typical High $40.74 | Professional | None | $13.80 | $30.20 | $40.74 |
United Setting Professional Modifier None Typical Low $12.59 Median $12.59 Typical High $16.98 | Professional | None | $12.59 | $12.59 | $16.98 |
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 $6.46 Median $6.46 Typical High $7.94 | Professional | 52 · Reduced service | $6.46 | $6.46 | $7.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.57 Median $2.57 Typical High $3.16 | Professional | 53 · Discontinued | $2.57 | $2.57 | $3.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.95 Median $1.95 Typical High $2.34 | Professional | 55 · Aftercare only | $1.95 | $1.95 | $2.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.29 Median $1.29 Typical High $1.58 | Professional | 56 · Pre-op care only | $1.29 | $1.29 | $1.58 |
Where Georgia sits
The same service costs 1.5 times more in Alaska 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· 28th of 51
$12.88
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.