How much rates vary
Facilitymedian $501 · 10th to 90th $110 to $3,388Professionalmedian $155 · 10th to 90th $98 to $295
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 $97.72 Median $3,548.13 Typical High $7,585.78 | Facility | None | $97.72 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $147.91 Typical High $354.81 | Professional | None | $89.13 | $147.91 | $354.81 |
Ambetter Setting Professional Modifier None Typical Low $107.15 Median $218.78 Typical High $275.42 | Professional | None | $107.15 | $218.78 | $275.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $380.19 Median $776.25 Typical High $3,630.78 | Facility | None | $380.19 | $776.25 | $3,630.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $97.72 Median $154.88 Typical High $269.15 | Professional | None | $97.72 | $154.88 | $269.15 |
CareSource Setting Professional Modifier None Typical Low $138.04 Median $151.36 Typical High $165.96 | Professional | None | $138.04 | $151.36 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $144.54 Typical High $602.56 | Facility | None | $107.15 | $144.54 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $199.53 Typical High $309.03 | Professional | None | $87.10 | $199.53 | $309.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $107.15 Median $173.78 Typical High $199.53 | Professional | None | $107.15 | $173.78 | $199.53 |
Oscar Health Setting Professional Modifier None Typical Low $134.90 Median $190.55 Typical High $288.40 | Professional | None | $134.90 | $190.55 | $288.40 |
United Setting Facility Modifier None Typical Low $79.43 Median $158.49 Typical High $1,778.28 | Facility | None | $79.43 | $158.49 | $1,778.28 |
United Setting Professional Modifier None Typical Low $109.65 Median $186.21 Typical High $371.54 | Professional | None | $109.65 | $186.21 | $371.54 |
8 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 $44.67 Median $64.57 Typical High $77.62 | Professional | 52 · Reduced service | $44.67 | $64.57 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $25.70 Typical High $31.62 | Professional | 53 · Discontinued | $17.78 | $25.70 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $95.50 Typical High $117.49 | Professional | 54 · Surgery only | $67.61 | $95.50 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $19.50 Typical High $23.44 | Professional | 55 · Aftercare only | $13.49 | $19.50 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $12.88 Typical High $15.85 | Professional | 56 · Pre-op care only | $8.91 | $12.88 | $15.85 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $63.10 Median $89.13 Typical High $109.65 | Professional | 78 · Unplanned return to OR | $63.10 | $89.13 | $109.65 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $87.10 Median $131.83 Typical High $138.04 | Professional | 51 · Multiple procedures | $87.10 | $131.83 | $138.04 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | 59 · Distinct service | $302.00 | $302.00 | $302.00 |
Where Georgia sits
The same service costs 3.7 times more in Alaska than in Kentucky. 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· 23rd of 51
$162
AK $427KY $115
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.