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 $3.55 Median $3.55 Typical High $3.55 | Facility | None | $3.55 | $3.55 | $3.55 |
Aetna Setting Professional Modifier None Typical Low $3.47 Median $3.55 Typical High $3.55 | Professional | None | $3.47 | $3.55 | $3.55 |
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 $3.16 Median $3.72 Typical High $5.25 | Professional | None | $3.16 | $3.72 | $5.25 |
Cigna Setting Facility Modifier None Typical Low $3.72 Median $4.27 Typical High $6.76 | Facility | None | $3.72 | $4.27 | $6.76 |
Cigna Setting Professional Modifier None Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | None | $3.72 | $3.72 | $3.72 |
Kaiser Permanente Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $36.31 | Professional | None | $21.88 | $21.88 | $36.31 |
United Setting Professional Modifier None Typical Low $3.72 Median $3.72 Typical High $5.75 | Professional | None | $3.72 | $3.72 | $5.75 |
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 $1.74 Median $1.78 Typical High $1.78 | Professional | 52 · Reduced service | $1.74 | $1.78 | $1.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.71 Median $0.71 Typical High $0.71 | Professional | 53 · Discontinued | $0.71 | $0.71 | $0.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.52 Median $0.52 Typical High $0.52 | Professional | 55 · Aftercare only | $0.52 | $0.52 | $0.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.35 Median $0.35 Typical High $0.35 | Professional | 56 · Pre-op care only | $0.35 | $0.35 | $0.35 |
Where Georgia sits
The same service costs 2.2 times more in Kansas than in Hawaii. 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· 33rd of 51
$3.72
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.