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 $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $61.66 | Professional | None | $60.26 | $60.26 | $61.66 |
Anthem BCBS Setting Facility Modifier None Typical Low $60.26 Median $134.90 Typical High $331.13 | Facility | None | $60.26 | $134.90 | $331.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $60.26 Median $69.18 Typical High $138.04 | Professional | None | $60.26 | $69.18 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $69.18 Typical High $109.65 | Facility | None | $61.66 | $69.18 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Kaiser Permanente Setting Professional Modifier None Typical Low $61.66 Median $131.83 Typical High $263.03 | Professional | None | $61.66 | $131.83 | $263.03 |
United Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $93.33 | Professional | None | $60.26 | $60.26 | $93.33 |
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 $30.20 Median $30.20 Typical High $30.90 | Professional | 52 · Reduced service | $30.20 | $30.20 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.02 Typical High $12.30 | Professional | 53 · Discontinued | $12.02 | $12.02 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $8.91 Typical High $9.33 | Professional | 55 · Aftercare only | $8.91 | $8.91 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.03 Typical High $6.17 | Professional | 56 · Pre-op care only | $6.03 | $6.03 | $6.17 |
Where Georgia sits
The same service costs 1.6 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· 31st of 51
$61.66
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.