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 $37.15 Median $37.15 Typical High $37.15 | Facility | None | $37.15 | $37.15 | $37.15 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $37.15 Median $85.11 Typical High $204.17 | Facility | None | $37.15 | $85.11 | $204.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.20 Median $42.66 Typical High $43.65 | Professional | None | $30.20 | $42.66 | $43.65 |
Cigna Setting Facility Modifier None Typical Low $38.02 Median $43.65 Typical High $69.18 | Facility | None | $38.02 | $43.65 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3.80 Median $3.80 Typical High $38.90 | Professional | None | $3.80 | $3.80 | $38.90 |
United Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $48.98 | Professional | None | $37.15 | $37.15 | $48.98 |
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 $18.62 Median $18.62 Typical High $18.62 | Professional | 52 · Reduced service | $18.62 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $7.41 Typical High $7.41 | Professional | 53 · Discontinued | $7.41 | $7.41 | $7.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $5.62 Typical High $5.62 | Professional | 55 · Aftercare only | $5.50 | $5.62 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | 56 · Pre-op care only | $3.72 | $3.72 | $3.72 |
Where Georgia sits
The same service costs 20.4 times more in Arizona 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· 7th of 51
$40.74
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.