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 $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $67.61 Typical High $67.61 | Professional | None | $66.07 | $67.61 | $67.61 |
Anthem BCBS Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $57.54 Median $70.79 Typical High $75.86 | Professional | None | $57.54 | $70.79 | $75.86 |
United Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $123.03 | Professional | None | $81.28 | $81.28 | $123.03 |
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 $33.11 Median $33.88 Typical High $33.88 | Professional | 52 · Reduced service | $33.11 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $13.49 Typical High $13.49 | Professional | 53 · Discontinued | $13.18 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | 55 · Aftercare only | $10.00 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $6.76 Typical High $6.76 | Professional | 56 · Pre-op care only | $6.61 | $6.76 | $6.76 |
Where Georgia sits
The same service costs 1.9 times more in Alabama 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· 40th of 51
$70.79
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.