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 $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $77.62 | Professional | None | $72.44 | $72.44 | $77.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $72.44 Median $165.96 Typical High $398.11 | Facility | None | $72.44 | $165.96 | $398.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $70.79 Median $72.44 Typical High $87.10 | Professional | None | $70.79 | $72.44 | $87.10 |
CareSource Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $134.90 Typical High $194.98 | Facility | None | $83.18 | $134.90 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $95.50 | Professional | None | $72.44 | $72.44 | $95.50 |
Kaiser Permanente Setting Professional Modifier None Typical Low $95.50 Median $112.20 Typical High $154.88 | Professional | None | $95.50 | $112.20 | $154.88 |
United Setting Professional Modifier None Typical Low $29.51 Median $74.13 Typical High $102.33 | Professional | None | $29.51 | $74.13 | $102.33 |
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 $36.31 Median $36.31 Typical High $38.90 | Professional | 52 · Reduced service | $36.31 | $36.31 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $14.45 Typical High $15.49 | Professional | 53 · Discontinued | $14.45 | $14.45 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $10.96 Typical High $11.48 | Professional | 55 · Aftercare only | $10.96 | $10.96 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.24 Typical High $7.76 | Professional | 56 · Pre-op care only | $7.24 | $7.24 | $7.76 |
Where Georgia sits
The same service costs 1.6 times more in Hawaii 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· 46th of 51
$72.44
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.