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 $31.62 Median $31.62 Typical High $31.62 | Facility | None | $31.62 | $31.62 | $31.62 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $42.66 | Professional | None | $31.62 | $31.62 | $42.66 |
Anthem BCBS Setting Facility Modifier None Typical Low $31.62 Median $72.44 Typical High $173.78 | Facility | None | $31.62 | $72.44 | $173.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $22.91 Median $31.62 Typical High $51.29 | Professional | None | $22.91 | $31.62 | $51.29 |
Cigna Setting Facility Modifier None Typical Low $35.48 Median $58.88 Typical High $85.11 | Facility | None | $35.48 | $58.88 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
Kaiser Permanente Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $57.54 | Professional | None | $28.18 | $28.18 | $57.54 |
United Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $54.95 | Professional | None | $31.62 | $31.62 | $54.95 |
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 $15.85 Median $15.85 Typical High $21.38 | Professional | 52 · Reduced service | $15.85 | $15.85 | $21.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $6.31 Typical High $8.51 | Professional | 53 · Discontinued | $6.31 | $6.31 | $8.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $4.79 Typical High $6.46 | Professional | 55 · Aftercare only | $4.79 | $4.79 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.16 Typical High $4.27 | Professional | 56 · Pre-op care only | $3.16 | $3.16 | $4.27 |
Where Georgia sits
The same service costs 3.8 times more in Alabama than in Virginia. 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· 47th of 51
$31.62
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.