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 $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $100.00 | Professional | None | $67.61 | $67.61 | $100.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $67.61 Median $234.42 Typical High $251.19 | Facility | None | $67.61 | $234.42 | $251.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $66.07 Median $67.61 Typical High $100.00 | Professional | None | $66.07 | $67.61 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $123.03 Typical High $181.97 | Facility | None | $75.86 | $123.03 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
Kaiser Permanente Setting Professional Modifier None Typical Low $79.43 Median $112.20 Typical High $186.21 | Professional | None | $79.43 | $112.20 | $186.21 |
United Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $117.49 | Professional | None | $67.61 | $67.61 | $117.49 |
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 $33.11 Typical High $45.71 | Professional | 52 · Reduced service | $33.11 | $33.11 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $13.49 Typical High $18.20 | Professional | 53 · Discontinued | $13.49 | $13.49 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.00 Typical High $13.80 | Professional | 55 · Aftercare only | $10.00 | $10.00 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $9.12 | Professional | 56 · Pre-op care only | $6.76 | $6.76 | $9.12 |
Where Georgia sits
The same service costs 2.0 times more in Oklahoma than in New Mexico. 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
$67.61
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.