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 $20.42 Median $20.42 Typical High $20.42 | Facility | None | $20.42 | $20.42 | $20.42 |
Aetna Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $43.65 | Professional | None | $20.42 | $20.42 | $43.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $32.36 Median $102.33 Typical High $117.49 | Facility | None | $32.36 | $102.33 | $117.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $47.86 | Professional | None | $20.42 | $20.42 | $47.86 |
Cigna Setting Facility Modifier None Typical Low $28.84 Median $37.15 Typical High $54.95 | Facility | None | $28.84 | $37.15 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | None | $20.42 | $20.42 | $20.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $41.69 Median $239.88 Typical High $239.88 | Professional | None | $41.69 | $239.88 | $239.88 |
United Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $56.23 | Professional | None | $32.36 | $32.36 | $56.23 |
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 $10.23 Median $10.23 Typical High $21.88 | Professional | 52 · Reduced service | $10.23 | $10.23 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $4.07 Typical High $8.71 | Professional | 53 · Discontinued | $4.07 | $4.07 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.02 Median $3.02 Typical High $6.46 | Professional | 55 · Aftercare only | $3.02 | $3.02 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $2.04 Typical High $4.37 | Professional | 56 · Pre-op care only | $2.04 | $2.04 | $4.37 |
Where Georgia sits
The same service costs 3.8 times more in Oklahoma than in Delaware. 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· 48th of 51
$20.42
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.