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 $53.70 Median $95.50 Typical High $104.71 | Facility | None | $53.70 | $95.50 | $104.71 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $83.18 Typical High $109.65 | Professional | None | $53.70 | $83.18 | $109.65 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $26.92 Median $36.31 Typical High $50.12 | Professional | 52 · Reduced service | $26.92 | $36.31 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $14.45 Typical High $20.42 | Professional | 53 · Discontinued | $10.96 | $14.45 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $10.72 Typical High $15.14 | Professional | 55 · Aftercare only | $8.13 | $10.72 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $7.24 Typical High $10.00 | Professional | 56 · Pre-op care only | $5.37 | $7.24 | $10.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $60.26 Median $95.50 Typical High $120.23 | Professional | None | $60.26 | $95.50 | $120.23 |
CareSource Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $91.20 Typical High $141.25 | Professional | None | $58.88 | $91.20 | $141.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $63.10 Median $112.20 Typical High $169.82 | Professional | None | $63.10 | $112.20 | $169.82 |
Oscar Health Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
United Setting Professional Modifier None Typical Low $30.20 Median $75.86 Typical High $123.03 | Professional | None | $30.20 | $75.86 | $123.03 |
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 |
|---|---|---|---|---|---|
Oscar Health Setting Professional Modifier NDW Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | NDW | $60.26 | $60.26 | $60.26 |
Oscar Health Setting Professional Modifier NES Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | NES | $60.26 | $60.26 | $60.26 |
Oscar Health Setting Professional Modifier NEW Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | NEW | $60.26 | $60.26 | $60.26 |
Oscar Health Setting Professional Modifier NNW Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | NNW | $60.26 | $60.26 | $60.26 |
United Setting Professional Modifier XC Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | XC | $501.19 | $501.19 | $501.19 |
Where Georgia sits
The same service costs 3.0 times more in Alaska than in Florida. 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· 19th of 51
$83.18
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.