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 $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
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 $52.48 Median $56.23 Typical High $57.54 | Professional | None | $52.48 | $56.23 | $57.54 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $58.88 Typical High $93.33 | Facility | None | $52.48 | $58.88 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $58.88 | Professional | None | $52.48 | $52.48 | $58.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $50.12 Median $165.96 Typical High $165.96 | Professional | None | $50.12 | $165.96 | $165.96 |
United Setting Professional Modifier None Typical Low $58.88 Median $63.10 Typical High $83.18 | Professional | None | $58.88 | $63.10 | $83.18 |
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 $24.55 Median $24.55 Typical High $24.55 | Professional | 52 · Reduced service | $24.55 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | 53 · Discontinued | $9.77 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $7.41 Typical High $7.41 | Professional | 55 · Aftercare only | $7.41 | $7.41 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | 56 · Pre-op care only | $4.90 | $4.90 | $4.90 |
Where Georgia sits
The same service costs 1.6 times more in Alaska than in Pennsylvania. 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· 13th of 51
$56.23
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.