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 $0.68 Median $0.68 Typical High $0.95 | Facility | None | $0.68 | $0.68 | $0.95 |
Aetna Setting Professional Modifier None Typical Low $0.68 Median $0.85 Typical High $0.98 | Professional | None | $0.68 | $0.85 | $0.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.81 Median $1.00 Typical High $1.26 | Professional | None | $0.81 | $1.00 | $1.26 |
Cigna Setting Professional Modifier None Typical Low $0.38 Median $0.85 Typical High $0.85 | Professional | None | $0.38 | $0.85 | $0.85 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.07 Median $2.19 Typical High $2.24 | Professional | None | $1.07 | $2.19 | $2.24 |
United Setting Professional Modifier None Typical Low $1.02 Median $1.35 Typical High $3.47 | Professional | None | $1.02 | $1.35 | $3.47 |
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 52 · Reduced service Typical Low $0.34 Median $0.40 Typical High $0.49 | Professional | 52 · Reduced service | $0.34 | $0.40 | $0.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.13 Median $0.16 Typical High $0.19 | Professional | 53 · Discontinued | $0.13 | $0.16 | $0.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.10 Median $0.12 Typical High $0.15 | Professional | 55 · Aftercare only | $0.10 | $0.12 | $0.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.07 Median $0.08 Typical High $0.10 | Professional | 56 · Pre-op care only | $0.07 | $0.08 | $0.10 |
Ambetter Setting Professional Modifier GB · Resubmitted, left demonstration Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | GB · Resubmitted, left demonstration | $51.29 | $51.29 | $51.29 |
Where Georgia sits
The same service costs 104.7 times more in Wyoming than in Connecticut. 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· 38th of 51
$1.00
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.