How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $28.18 Median $28.18 Typical High $28.18 | Facility | None | $28.18 | $28.18 | $28.18 |
Aetna Setting Professional Modifier None Typical Low $27.54 Median $28.18 Typical High $28.84 | Professional | None | $27.54 | $28.18 | $28.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.02 Median $0.05 Typical High $0.05 | Facility | None | $0.02 | $0.05 | $0.05 |
Anthem BCBS Setting Professional Modifier None Typical Low $25.70 Median $32.36 Typical High $32.36 | Professional | None | $25.70 | $32.36 | $32.36 |
Cigna Setting Facility Modifier None Typical Low $28.84 Median $32.36 Typical High $52.48 | Facility | None | $28.84 | $32.36 | $52.48 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $28.84 Median $66.07 Typical High $109.65 | Professional | None | $28.84 | $66.07 | $109.65 |
United Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $44.67 | Professional | None | $33.88 | $33.88 | $44.67 |
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 $13.80 Median $14.13 Typical High $14.45 | Professional | 52 · Reduced service | $13.80 | $14.13 | $14.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $5.62 Typical High $5.75 | Professional | 53 · Discontinued | $5.62 | $5.62 | $5.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.17 Median $4.27 Typical High $4.37 | Professional | 55 · Aftercare only | $4.17 | $4.27 | $4.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $2.82 Typical High $2.88 | Professional | 56 · Pre-op care only | $2.82 | $2.82 | $2.88 |
Where Georgia sits
The same service costs 1.7 times more in Arizona than in Oklahoma. 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· 30th of 51
$32.36
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.