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 $4.47 Median $4.47 Typical High $4.47 | Facility | None | $4.47 | $4.47 | $4.47 |
Aetna Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $5.62 | Professional | None | $4.47 | $4.47 | $5.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $4.47 Median $10.23 Typical High $24.55 | Facility | None | $4.47 | $10.23 | $24.55 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.07 Median $4.47 Typical High $11.75 | Professional | None | $4.07 | $4.47 | $11.75 |
Cigna Setting Facility Modifier None Typical Low $5.13 Median $8.32 Typical High $12.02 | Facility | None | $5.13 | $8.32 | $12.02 |
Cigna Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | None | $4.47 | $4.47 | $4.47 |
Kaiser Permanente Setting Professional Modifier None Typical Low $5.01 Median $8.32 Typical High $38.90 | Professional | None | $5.01 | $8.32 | $38.90 |
United Setting Professional Modifier None Typical Low $4.17 Median $4.17 Typical High $7.41 | Professional | None | $4.17 | $4.17 | $7.41 |
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 $2.24 Median $2.24 Typical High $2.82 | Professional | 52 · Reduced service | $2.24 | $2.24 | $2.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.89 Median $0.89 Typical High $1.12 | Professional | 53 · Discontinued | $0.89 | $0.89 | $1.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.68 Median $0.68 Typical High $0.85 | Professional | 55 · Aftercare only | $0.68 | $0.68 | $0.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.45 Median $0.45 Typical High $0.56 | Professional | 56 · Pre-op care only | $0.45 | $0.45 | $0.56 |
Where Georgia sits
The same service costs 5.9 times more in Texas than in Rhode Island. 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· 49th of 51
$4.47
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.