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 $1.62 Median $1.66 Typical High $1.95 | Facility | None | $1.62 | $1.66 | $1.95 |
Aetna Setting Professional Modifier None Typical Low $1.62 Median $1.66 Typical High $2.51 | Professional | None | $1.62 | $1.66 | $2.51 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.66 Median $3.72 Typical High $9.12 | Facility | None | $1.66 | $3.72 | $9.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.32 Median $1.66 Typical High $1.95 | Professional | None | $1.32 | $1.66 | $1.95 |
Cigna Setting Facility Modifier None Typical Low $1.86 Median $3.02 Typical High $4.47 | Facility | None | $1.86 | $3.02 | $4.47 |
Cigna Setting Professional Modifier None Typical Low $1.66 Median $1.66 Typical High $1.66 | Professional | None | $1.66 | $1.66 | $1.66 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.82 Median $1.95 Typical High $4.07 | Professional | None | $1.82 | $1.95 | $4.07 |
United Setting Professional Modifier None Typical Low $1.86 Median $1.86 Typical High $3.24 | Professional | None | $1.86 | $1.86 | $3.24 |
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 $0.83 Median $0.83 Typical High $1.26 | Professional | 52 · Reduced service | $0.83 | $0.83 | $1.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.33 Median $0.33 Typical High $0.50 | Professional | 53 · Discontinued | $0.33 | $0.33 | $0.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.25 Median $0.25 Typical High $0.38 | Professional | 55 · Aftercare only | $0.25 | $0.25 | $0.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.17 Median $0.17 Typical High $0.25 | Professional | 56 · Pre-op care only | $0.17 | $0.17 | $0.25 |
Where Georgia sits
The same service costs 3.2 times more in Texas 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
$1.66
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.