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 $0.58 Median $0.58 Typical High $0.58 | Facility | None | $0.58 | $0.58 | $0.58 |
Aetna Setting Professional Modifier None Typical Low $0.56 Median $0.58 Typical High $0.91 | Professional | None | $0.56 | $0.58 | $0.91 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.68 Median $2.34 Typical High $2.51 | Facility | None | $0.68 | $2.34 | $2.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.46 Median $0.58 Typical High $1.86 | Professional | None | $0.46 | $0.58 | $1.86 |
Cigna Setting Facility Modifier None Typical Low $0.66 Median $1.07 Typical High $1.58 | Facility | None | $0.66 | $1.07 | $1.58 |
Cigna Setting Professional Modifier None Typical Low $0.58 Median $0.58 Typical High $0.58 | Professional | None | $0.58 | $0.58 | $0.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $0.74 Median $3.02 Typical High $5.01 | Professional | None | $0.74 | $3.02 | $5.01 |
United Setting Professional Modifier None Typical Low $0.68 Median $0.68 Typical High $1.20 | Professional | None | $0.68 | $0.68 | $1.20 |
5 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 $0.28 Median $0.28 Typical High $0.46 | Professional | 52 · Reduced service | $0.28 | $0.28 | $0.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.12 Median $0.12 Typical High $0.18 | Professional | 53 · Discontinued | $0.12 | $0.12 | $0.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $0.44 Median $0.44 Typical High $0.52 | Professional | 54 · Surgery only | $0.44 | $0.44 | $0.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.09 Median $0.09 Typical High $0.14 | Professional | 55 · Aftercare only | $0.09 | $0.09 | $0.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.06 Typical High $0.09 | Professional | 56 · Pre-op care only | $0.06 | $0.06 | $0.09 |
Where Georgia sits
The same service costs 4.1 times more in Wyoming than in Delaware. 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
$0.58
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.