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 $0.05 Median $0.06 Typical High $0.09 | Facility | None | $0.05 | $0.06 | $0.09 |
Aetna Setting Professional Modifier None Typical Low $0.06 Median $0.06 Typical High $0.31 | Professional | None | $0.06 | $0.06 | $0.31 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.03 Median $0.03 Typical High $0.03 | Professional | 52 · Reduced service | $0.03 | $0.03 | $0.03 |
Ambetter Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | None | $6.03 | $6.03 | $6.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.06 Median $0.11 Typical High $0.33 | Facility | None | $0.06 | $0.11 | $0.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.06 Median $0.06 Typical High $0.09 | Professional | None | $0.06 | $0.06 | $0.09 |
CareSource Setting Professional Modifier None Typical Low $0.08 Median $0.08 Typical High $0.13 | Professional | None | $0.08 | $0.08 | $0.13 |
Cigna Setting Facility Modifier None Typical Low $0.08 Median $0.10 Typical High $0.14 | Facility | None | $0.08 | $0.10 | $0.14 |
Cigna Setting Professional Modifier None Typical Low $0.06 Median $0.06 Typical High $0.07 | Professional | None | $0.06 | $0.06 | $0.07 |
Kaiser Permanente Setting Professional Modifier None Typical Low $0.05 Median $0.13 Typical High $1.12 | Professional | None | $0.05 | $0.13 | $1.12 |
Oscar Health Setting Professional Modifier None Typical Low $0.05 Median $0.08 Typical High $0.09 | Professional | None | $0.05 | $0.08 | $0.09 |
United Setting Professional Modifier None Typical Low $0.08 Median $0.08 Typical High $0.12 | Professional | None | $0.08 | $0.08 | $0.12 |
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 53 · Discontinued Typical Low $0.02 Median $0.08 Typical High $0.10 | Professional | 53 · Discontinued | $0.02 | $0.08 | $0.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.02 Median $0.06 Typical High $0.08 | Professional | 55 · Aftercare only | $0.02 | $0.06 | $0.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.05 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.05 |
Ambetter Setting Professional Modifier JW · Drug discarded Typical Low $7.94 Median $10.00 Typical High $10.00 | Professional | JW · Drug discarded | $7.94 | $10.00 | $10.00 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | JZ · No drug discarded | $7.94 | $7.94 | $7.94 |
Where Georgia sits
The same service costs 8.5 times more in Wyoming than in New Jersey. 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· 33rd of 51
$0.06
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.