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 $154.88 Median $2,754.23 Typical High $7,413.10 | Facility | None | $154.88 | $2,754.23 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $213.80 Typical High $512.86 | Professional | None | $138.04 | $213.80 | $512.86 |
Ambetter Setting Professional Modifier None Typical Low $208.93 Median $275.42 Typical High $446.68 | Professional | None | $208.93 | $275.42 | $446.68 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $851.14 Typical High $4,570.88 | Facility | None | $389.05 | $851.14 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $158.49 Median $229.09 Typical High $407.38 | Professional | None | $158.49 | $229.09 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $851.14 Typical High $1,122.02 | Facility | None | $398.11 | $851.14 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $302.00 Typical High $457.09 | Professional | None | $138.04 | $302.00 | $457.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $169.82 Median $257.04 Typical High $338.84 | Professional | None | $169.82 | $257.04 | $338.84 |
Oscar Health Setting Professional Modifier None Typical Low $213.80 Median $281.84 Typical High $436.52 | Professional | None | $213.80 | $281.84 | $436.52 |
United Setting Facility Modifier None Typical Low $501.19 Median $724.44 Typical High $3,548.13 | Facility | None | $501.19 | $724.44 | $3,548.13 |
United Setting Professional Modifier None Typical Low $169.82 Median $275.42 Typical High $549.54 | Professional | None | $169.82 | $275.42 | $549.54 |
6 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 $69.18 Median $95.50 Typical High $117.49 | Professional | 52 · Reduced service | $69.18 | $95.50 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $38.02 Typical High $46.77 | Professional | 53 · Discontinued | $27.54 | $38.02 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $144.54 Typical High $173.78 | Professional | 54 · Surgery only | $104.71 | $144.54 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $28.84 Typical High $34.67 | Professional | 55 · Aftercare only | $20.89 | $28.84 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $19.05 Typical High $23.44 | Professional | 56 · Pre-op care only | $13.80 | $19.05 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $134.90 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $97.72 | $134.90 | $162.18 |
Where Georgia sits
The same service costs 4.6 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
$269
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.