How much rates vary
Facilitymedian $550 · 10th to 90th $155 to $3,548Professionalmedian $174 · 10th to 90th $110 to $324
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 $107.15 Median $3,548.13 Typical High $7,585.78 | Facility | None | $107.15 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $162.18 Typical High $389.05 | Professional | None | $100.00 | $162.18 | $389.05 |
Ambetter Setting Professional Modifier None Typical Low $75.86 Median $147.91 Typical High $302.00 | Professional | None | $75.86 | $147.91 | $302.00 |
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 $112.20 Median $169.82 Typical High $302.00 | Professional | None | $112.20 | $169.82 | $302.00 |
CareSource Setting Professional Modifier None Typical Low $154.88 Median $165.96 Typical High $181.97 | Professional | None | $154.88 | $165.96 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $158.49 Typical High $602.56 | Facility | None | $117.49 | $158.49 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $218.78 Typical High $338.84 | Professional | None | $95.50 | $218.78 | $338.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $114.82 Median $190.55 Typical High $257.04 | Professional | None | $114.82 | $190.55 | $257.04 |
Oscar Health Setting Professional Modifier None Typical Low $147.91 Median $204.17 Typical High $316.23 | Professional | None | $147.91 | $204.17 | $316.23 |
United Setting Facility Modifier None Typical Low $331.13 Median $501.19 Typical High $2,454.71 | Facility | None | $331.13 | $501.19 | $2,454.71 |
United Setting Professional Modifier None Typical Low $120.23 Median $204.17 Typical High $407.38 | Professional | None | $120.23 | $204.17 | $407.38 |
9 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 $48.98 Median $70.79 Typical High $89.13 | Professional | 52 · Reduced service | $48.98 | $70.79 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $28.18 Typical High $35.48 | Professional | 53 · Discontinued | $19.50 | $28.18 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $107.15 Typical High $131.83 | Professional | 54 · Surgery only | $74.13 | $107.15 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $21.38 Typical High $26.30 | Professional | 55 · Aftercare only | $14.79 | $21.38 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $14.13 Typical High $17.78 | Professional | 56 · Pre-op care only | $9.77 | $14.13 | $17.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $100.00 Typical High $123.03 | Professional | 78 · Unplanned return to OR | $69.18 | $100.00 | $123.03 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $87.10 Median $144.54 Typical High $151.36 | Professional | 51 · Multiple procedures | $87.10 | $144.54 | $151.36 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $199.53 Median $331.13 Typical High $331.13 | Professional | 59 · Distinct service | $199.53 | $331.13 | $331.13 |
Ambetter Setting Professional Modifier 79 · Unrelated procedure after surgery Typical Low $151.36 Median $165.96 Typical High $165.96 | Professional | 79 · Unrelated procedure after surgery | $151.36 | $165.96 | $165.96 |
Where Georgia sits
The same service costs 3.8 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· 20th of 51
$186
AK $525KY $138
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.