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 $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $131.83 | Professional | None | $67.61 | $67.61 | $131.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $79.43 Median $239.88 Typical High $295.12 | Facility | None | $79.43 | $239.88 | $295.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $208.93 | Professional | None | $67.61 | $67.61 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $109.65 Typical High $158.49 | Facility | None | $85.11 | $109.65 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
Kaiser Permanente Setting Professional Modifier None Typical Low $100.00 Median $109.65 Typical High $457.09 | Professional | None | $100.00 | $109.65 | $457.09 |
United Setting Professional Modifier None Typical Low $79.43 Median $83.18 Typical High $112.20 | Professional | None | $79.43 | $83.18 | $112.20 |
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 $13.49 Median $13.49 Typical High $13.49 | Professional | 53 · Discontinued | $13.49 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.00 Typical High $10.23 | Professional | 55 · Aftercare only | $10.00 | $10.00 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | 56 · Pre-op care only | $6.76 | $6.76 | $6.76 |
Where Georgia sits
The same service costs 2.7 times more in South Carolina than in Georgia. 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· 51st of 51
$67.61
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.