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 $11.22 Median $11.48 Typical High $11.48 | Facility | None | $11.22 | $11.48 | $11.48 |
Aetna Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $16.60 | Professional | None | $11.48 | $11.48 | $16.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $11.75 Median $39.81 Typical High $42.66 | Facility | None | $11.75 | $39.81 | $42.66 |
Anthem BCBS Setting Professional Modifier None Typical Low $9.12 Median $11.48 Typical High $13.18 | Professional | None | $9.12 | $11.48 | $13.18 |
Cigna Setting Facility Modifier None Typical Low $12.88 Median $20.89 Typical High $30.20 | Facility | None | $12.88 | $20.89 | $30.20 |
Cigna Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | None | $11.48 | $11.48 | $11.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $12.02 Median $61.66 Typical High $70.79 | Professional | None | $12.02 | $61.66 | $70.79 |
United Setting Professional Modifier None Typical Low $11.75 Median $11.75 Typical High $18.62 | Professional | None | $11.75 | $11.75 | $18.62 |
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 $5.62 Median $5.62 Typical High $7.76 | Professional | 52 · Reduced service | $5.62 | $5.62 | $7.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.29 Median $2.29 Typical High $3.16 | Professional | 53 · Discontinued | $2.29 | $2.29 | $3.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.70 Median $1.70 Typical High $2.34 | Professional | 55 · Aftercare only | $1.70 | $1.70 | $2.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.12 Typical High $1.58 | Professional | 56 · Pre-op care only | $1.12 | $1.12 | $1.58 |
Where Georgia sits
The same service costs 1.8 times more in Alaska than in Georgia. 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· 51st of 51
$11.48
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.