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 $2.19 Median $2.19 Typical High $2.19 | Facility | None | $2.19 | $2.19 | $2.19 |
Aetna Setting Professional Modifier None Typical Low $2.14 Median $2.19 Typical High $2.19 | Professional | None | $2.14 | $2.19 | $2.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.74 Median $2.14 Typical High $2.24 | Professional | None | $1.74 | $2.14 | $2.24 |
Cigna Setting Facility Modifier None Typical Low $2.24 Median $2.51 Typical High $4.07 | Facility | None | $2.24 | $2.51 | $4.07 |
Cigna Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $2.24 | Professional | None | $2.24 | $2.24 | $2.24 |
United Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $3.47 | Professional | None | $2.24 | $2.24 | $3.47 |
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 $1.07 Median $1.10 Typical High $1.10 | Professional | 52 · Reduced service | $1.07 | $1.10 | $1.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.43 Median $0.44 Typical High $0.44 | Professional | 53 · Discontinued | $0.43 | $0.44 | $0.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.32 Median $0.33 Typical High $0.33 | Professional | 55 · Aftercare only | $0.32 | $0.33 | $0.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.22 Median $0.22 Typical High $0.22 | Professional | 56 · Pre-op care only | $0.22 | $0.22 | $0.22 |
Where Georgia sits
The same service costs 128.8 times more in Kansas than in New York. 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· 49th of 51
$2.14
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.