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 $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | None | $69.18 | $69.18 | $69.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $39.81 Median $57.54 Typical High $60.26 | Professional | None | $39.81 | $57.54 | $60.26 |
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 $114.82 Median $128.82 Typical High $154.88 | Professional | None | $114.82 | $128.82 | $154.88 |
United Setting Professional Modifier None Typical Low $85.11 Median $125.89 Typical High $169.82 | Professional | None | $85.11 | $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 $33.88 Median $33.88 Typical High $33.88 | Professional | 52 · Reduced service | $33.88 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | 53 · Discontinued | $13.80 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | 55 · Aftercare only | $10.23 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $6.92 Typical High $6.92 | Professional | 56 · Pre-op care only | $6.92 | $6.92 | $6.92 |
Where Georgia sits
The same service costs 2.7 times more in North Dakota than in North Carolina. 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· 50th of 51
$58.88
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.