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 $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.02 Median $0.05 Typical High $39.81 | Facility | None | $0.02 | $0.05 | $39.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $36.31 Median $40.74 Typical High $43.65 | Professional | None | $36.31 | $40.74 | $43.65 |
CareSource Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Cigna Setting Facility Modifier None Typical Low $30.20 Median $33.88 Typical High $53.70 | Facility | None | $30.20 | $33.88 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Kaiser Permanente Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $87.10 | Professional | None | $38.02 | $38.02 | $87.10 |
United Setting Professional Modifier None Typical Low $40.74 Median $42.66 Typical High $56.23 | Professional | None | $40.74 | $42.66 | $56.23 |
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 $21.38 Median $21.38 Typical High $21.38 | Professional | 52 · Reduced service | $21.38 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | 53 · Discontinued | $8.51 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $6.31 Typical High $6.31 | Professional | 55 · Aftercare only | $6.31 | $6.31 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | 56 · Pre-op care only | $4.27 | $4.27 | $4.27 |
Where Georgia sits
The same service costs 2.0 times more in Alaska than in New Mexico. 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· 37th of 51
$40.74
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.