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 $3.55 Median $3.55 Typical High $3.55 | Facility | None | $3.55 | $3.55 | $3.55 |
Aetna Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $4.57 | Professional | None | $3.55 | $3.55 | $4.57 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.55 Median $8.13 Typical High $19.50 | Facility | None | $3.55 | $8.13 | $19.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.82 Median $3.55 Typical High $9.77 | Professional | None | $2.82 | $3.55 | $9.77 |
Cigna Setting Facility Modifier None Typical Low $3.98 Median $6.61 Typical High $9.55 | Facility | None | $3.98 | $6.61 | $9.55 |
Cigna Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | None | $3.55 | $3.55 | $3.55 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2.04 Median $2.04 Typical High $11.48 | Professional | None | $2.04 | $2.04 | $11.48 |
United Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $6.03 | Professional | None | $3.39 | $3.39 | $6.03 |
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 $1.78 Median $1.78 Typical High $2.29 | Professional | 52 · Reduced service | $1.78 | $1.78 | $2.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.71 Median $0.71 Typical High $0.91 | Professional | 53 · Discontinued | $0.71 | $0.71 | $0.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.52 Median $0.52 Typical High $0.69 | Professional | 55 · Aftercare only | $0.52 | $0.52 | $0.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.36 Median $0.36 Typical High $0.46 | Professional | 56 · Pre-op care only | $0.36 | $0.36 | $0.46 |
Where Georgia sits
The same service costs 4.0 times more in Oklahoma 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· 48th of 51
$3.55
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.