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 $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $87.10 Typical High $87.10 | Professional | None | $85.11 | $87.10 | $87.10 |
Anthem BCBS Setting Facility Modifier None Typical Low $87.10 Median $194.98 Typical High $478.63 | Facility | None | $87.10 | $194.98 | $478.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $69.18 Median $93.33 Typical High $97.72 | Professional | None | $69.18 | $93.33 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $100.00 Typical High $158.49 | Facility | None | $89.13 | $100.00 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $123.03 | Professional | None | $89.13 | $89.13 | $123.03 |
United Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $131.83 | Professional | None | $87.10 | $87.10 | $131.83 |
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 $42.66 Median $43.65 Typical High $43.65 | Professional | 52 · Reduced service | $42.66 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $17.38 Typical High $17.38 | Professional | 53 · Discontinued | $16.98 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $12.88 Typical High $12.88 | Professional | 55 · Aftercare only | $12.88 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.71 Typical High $8.71 | Professional | 56 · Pre-op care only | $8.51 | $8.71 | $8.71 |
Where Georgia sits
The same service costs 1.6 times more in Alaska than in Texas. 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· 29th of 51
$89.13
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.