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 $10.00 Median $10.00 Typical High $10.00 | Facility | None | $10.00 | $10.00 | $10.00 |
Aetna Setting Professional Modifier None Typical Low $9.77 Median $10.00 Typical High $10.00 | Professional | None | $9.77 | $10.00 | $10.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.24 Median $11.22 Typical High $13.49 | Facility | None | $3.24 | $11.22 | $13.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.00 Median $11.48 Typical High $23.99 | Professional | None | $10.00 | $11.48 | $23.99 |
Cigna Setting Facility Modifier None Typical Low $10.23 Median $11.48 Typical High $18.20 | Facility | None | $10.23 | $11.48 | $18.20 |
Cigna Setting Professional Modifier None Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | None | $10.23 | $10.23 | $10.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $10.23 Median $27.54 Typical High $30.20 | Professional | None | $10.23 | $27.54 | $30.20 |
United Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $20.89 | Professional | None | $10.00 | $10.00 | $20.89 |
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 $4.90 Median $5.01 Typical High $5.01 | Professional | 52 · Reduced service | $4.90 | $5.01 | $5.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.95 Median $2.00 Typical High $2.00 | Professional | 53 · Discontinued | $1.95 | $2.00 | $2.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.48 Median $1.48 Typical High $1.48 | Professional | 55 · Aftercare only | $1.48 | $1.48 | $1.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.98 Median $1.00 Typical High $1.00 | Professional | 56 · Pre-op care only | $0.98 | $1.00 | $1.00 |
Where Georgia sits
The same service costs 9.1 times more in Alabama than in Virginia. 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· 21st of 51
$11.48
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.