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 $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $54.95 | Professional | None | $42.66 | $42.66 | $54.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $40.74 Median $141.25 Typical High $147.91 | Facility | None | $40.74 | $141.25 | $147.91 |
Anthem BCBS Setting Professional Modifier None Typical Low $33.88 Median $42.66 Typical High $43.65 | Professional | None | $33.88 | $42.66 | $43.65 |
Cigna Setting Facility Modifier None Typical Low $47.86 Median $77.62 Typical High $114.82 | Facility | None | $47.86 | $77.62 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
Kaiser Permanente Setting Professional Modifier None Typical Low $39.81 Median $52.48 Typical High $87.10 | Professional | None | $39.81 | $52.48 | $87.10 |
United Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $60.26 | Professional | None | $40.74 | $40.74 | $60.26 |
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 $21.38 Median $21.38 Typical High $27.54 | Professional | 52 · Reduced service | $21.38 | $21.38 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $8.51 Typical High $10.96 | Professional | 53 · Discontinued | $8.51 | $8.51 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.46 Typical High $8.32 | Professional | 55 · Aftercare only | $6.46 | $6.46 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.27 Typical High $5.50 | Professional | 56 · Pre-op care only | $4.27 | $4.27 | $5.50 |
Where Georgia sits
The same service costs 1.7 times more in Arizona 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· 43rd of 51
$42.66
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.