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 $2.04 Median $2.04 Typical High $3.09 | Facility | None | $2.04 | $2.04 | $3.09 |
Aetna Setting Professional Modifier None Typical Low $2.04 Median $2.04 Typical High $5.37 | Professional | None | $2.04 | $2.04 | $5.37 |
Ambetter Setting Professional Modifier None Typical Low $2.04 Median $3.98 Typical High $3.98 | Professional | None | $2.04 | $3.98 | $3.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.04 Median $3.63 Typical High $10.96 | Facility | None | $2.04 | $3.63 | $10.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.04 Median $2.29 Typical High $4.07 | Professional | None | $2.04 | $2.29 | $4.07 |
CareSource Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $3.16 | Professional | None | $2.00 | $2.00 | $3.16 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.58 Median $3.89 Typical High $5.25 | Professional | None | $1.58 | $3.89 | $5.25 |
Oscar Health Setting Professional Modifier None Typical Low $1.95 Median $2.04 Typical High $2.29 | Professional | None | $1.95 | $2.04 | $2.29 |
United Setting Professional Modifier None Typical Low $2.04 Median $2.19 Typical High $3.09 | Professional | None | $2.04 | $2.19 | $3.09 |
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 $1.00 Median $1.00 Typical High $1.07 | Professional | 52 · Reduced service | $1.00 | $1.00 | $1.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.40 Median $0.40 Typical High $0.43 | Professional | 53 · Discontinued | $0.40 | $0.40 | $0.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.30 Median $0.30 Typical High $0.32 | Professional | 55 · Aftercare only | $0.30 | $0.30 | $0.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.20 Median $0.20 Typical High $0.21 | Professional | 56 · Pre-op care only | $0.20 | $0.20 | $0.21 |
Where Georgia sits
The same service costs 2.1 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· 10th of 51
$2.29
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.