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 $51.29 Median $51.29 Typical High $51.29 | Facility | None | $51.29 | $51.29 | $51.29 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $51.29 Typical High $51.29 | Professional | None | $50.12 | $51.29 | $51.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $50.12 Median $112.20 Typical High $275.42 | Facility | None | $50.12 | $112.20 | $275.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $22.39 Median $57.54 Typical High $144.54 | Professional | None | $22.39 | $57.54 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $58.88 Typical High $93.33 | Facility | None | $51.29 | $58.88 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $61.66 | Professional | None | $52.48 | $52.48 | $61.66 |
Kaiser Permanente Setting Professional Modifier None Typical Low $10.23 Median $51.29 Typical High $51.29 | Professional | None | $10.23 | $51.29 | $51.29 |
Oscar Health Setting Professional Modifier None Typical Low $8.91 Median $8.91 Typical High $10.00 | Professional | None | $8.91 | $8.91 | $10.00 |
United Setting Professional Modifier None Typical Low $50.12 Median $52.48 Typical High $72.44 | Professional | None | $50.12 | $52.48 | $72.44 |
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 $25.12 Median $25.12 Typical High $25.12 | Professional | 52 · Reduced service | $25.12 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $10.23 Typical High $10.23 | Professional | 53 · Discontinued | $10.00 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | 55 · Aftercare only | $7.59 | $7.59 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.13 Typical High $5.13 | Professional | 56 · Pre-op care only | $5.01 | $5.13 | $5.13 |
Where Georgia sits
The same service costs 6.6 times more in Alaska than in Hawaii. 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· 6th of 51
$52.48
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.