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 $1.20 Median $1.23 Typical High $4.07 | Facility | None | $1.20 | $1.23 | $4.07 |
Aetna Setting Professional Modifier None Typical Low $1.23 Median $1.23 Typical High $2.51 | Professional | None | $1.23 | $1.23 | $2.51 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.23 Median $2.75 Typical High $6.76 | Facility | None | $1.23 | $2.75 | $6.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.98 Median $1.23 Typical High $2.00 | Professional | None | $0.98 | $1.23 | $2.00 |
Cigna Setting Facility Modifier None Typical Low $1.38 Median $2.24 Typical High $3.31 | Facility | None | $1.38 | $2.24 | $3.31 |
Cigna Setting Professional Modifier None Typical Low $1.23 Median $1.23 Typical High $1.23 | Professional | None | $1.23 | $1.23 | $1.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.20 Median $1.86 Typical High $8.71 | Professional | None | $1.20 | $1.86 | $8.71 |
United Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $1.91 | Professional | None | $1.10 | $1.10 | $1.91 |
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 $0.62 Median $0.62 Typical High $0.74 | Professional | 52 · Reduced service | $0.62 | $0.62 | $0.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.24 Median $0.24 Typical High $0.28 | Professional | 53 · Discontinued | $0.24 | $0.24 | $0.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.18 Median $0.18 Typical High $0.22 | Professional | 55 · Aftercare only | $0.18 | $0.18 | $0.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.12 Median $0.12 Typical High $0.15 | Professional | 56 · Pre-op care only | $0.12 | $0.12 | $0.15 |
Where Georgia sits
The same service costs 3.8 times more in Texas than in Maryland. 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· 36th of 51
$1.23
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.