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 $10.96 Median $10.96 Typical High $10.96 | Facility | None | $10.96 | $10.96 | $10.96 |
Aetna Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $28.84 | Professional | None | $10.96 | $10.96 | $28.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $11.22 Median $38.90 Typical High $41.69 | Facility | None | $11.22 | $38.90 | $41.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.47 Median $10.96 Typical High $17.78 | Professional | None | $10.47 | $10.96 | $17.78 |
Cigna Setting Facility Modifier None Typical Low $12.59 Median $20.42 Typical High $29.51 | Facility | None | $12.59 | $20.42 | $29.51 |
Cigna Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | None | $10.96 | $10.96 | $10.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $12.88 Median $50.12 Typical High $77.62 | Professional | None | $12.88 | $50.12 | $77.62 |
United Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $19.95 | Professional | None | $11.22 | $11.22 | $19.95 |
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 $5.50 Median $5.50 Typical High $7.59 | Professional | 52 · Reduced service | $5.50 | $5.50 | $7.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.19 Median $2.19 Typical High $3.02 | Professional | 53 · Discontinued | $2.19 | $2.19 | $3.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.66 Median $1.66 Typical High $2.29 | Professional | 55 · Aftercare only | $1.66 | $1.66 | $2.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.10 Median $1.10 Typical High $1.51 | Professional | 56 · Pre-op care only | $1.10 | $1.10 | $1.51 |
Where Georgia sits
The same service costs 3.7 times more in Wyoming than in Georgia. 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· 51st of 51
$10.96
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.