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 $2.51 Median $2.51 Typical High $2.51 | Facility | None | $2.51 | $2.51 | $2.51 |
Aetna Setting Professional Modifier None Typical Low $2.51 Median $2.51 Typical High $2.63 | Professional | None | $2.51 | $2.51 | $2.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.00 Median $12.59 Typical High $15.49 | Professional | None | $10.00 | $12.59 | $15.49 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $158.49 Typical High $257.04 | Facility | None | $125.89 | $158.49 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $144.54 | Professional | None | $125.89 | $125.89 | $144.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $58.88 Median $128.82 Typical High $154.88 | Professional | None | $58.88 | $128.82 | $154.88 |
United Setting Professional Modifier None Typical Low $21.88 Median $125.89 Typical High $169.82 | Professional | None | $21.88 | $125.89 | $169.82 |
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 $1.26 Median $1.26 Typical High $1.32 | Professional | 52 · Reduced service | $1.26 | $1.26 | $1.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.50 Median $0.50 Typical High $0.52 | Professional | 53 · Discontinued | $0.50 | $0.50 | $0.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.37 Median $0.37 Typical High $0.39 | Professional | 55 · Aftercare only | $0.37 | $0.37 | $0.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.25 Median $0.25 Typical High $0.26 | Professional | 56 · Pre-op care only | $0.25 | $0.25 | $0.26 |
Where Georgia sits
The same service costs 50.1 times more in Massachusetts than in Indiana. 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· 27th of 51
$14.13
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.