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 $21.88 Median $21.88 Typical High $21.88 | Facility | None | $21.88 | $21.88 | $21.88 |
Aetna Setting Professional Modifier None Typical Low $21.38 Median $21.88 Typical High $21.88 | Professional | None | $21.38 | $21.88 | $21.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.02 Median $0.05 Typical High $0.05 | Facility | None | $0.02 | $0.05 | $0.05 |
Anthem BCBS Setting Professional Modifier None Typical Low $16.98 Median $20.89 Typical High $22.39 | Professional | None | $16.98 | $20.89 | $22.39 |
Cigna Setting Facility Modifier None Typical Low $20.89 Median $23.99 Typical High $38.02 | Facility | None | $20.89 | $23.99 | $38.02 |
Cigna Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | None | $20.89 | $20.89 | $20.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $75.86 | Professional | None | $45.71 | $45.71 | $75.86 |
United Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $32.36 | Professional | None | $20.89 | $20.89 | $32.36 |
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 $10.72 Median $10.96 Typical High $10.96 | Professional | 52 · Reduced service | $10.72 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.27 Median $4.37 Typical High $4.37 | Professional | 53 · Discontinued | $4.27 | $4.37 | $4.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $3.31 Typical High $3.31 | Professional | 55 · Aftercare only | $3.24 | $3.31 | $3.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.14 Median $2.19 Typical High $2.19 | Professional | 56 · Pre-op care only | $2.14 | $2.19 | $2.19 |
Where Georgia sits
The same service costs 1.9 times more in Kansas than in Connecticut. 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· 42nd of 51
$20.89
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.