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 $186.21 Median $3,630.78 Typical High $7,413.10 | Facility | None | $186.21 | $3,630.78 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $229.09 Typical High $537.03 | Professional | None | $151.36 | $229.09 | $537.03 |
Ambetter Setting Professional Modifier None Typical Low $158.49 Median $218.78 Typical High $229.09 | Professional | None | $158.49 | $218.78 | $229.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $512.86 Median $1,000.00 Typical High $4,570.88 | Facility | None | $512.86 | $1,000.00 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $173.78 Median $251.19 Typical High $446.68 | Professional | None | $173.78 | $251.19 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $891.25 Typical High $1,148.15 | Facility | None | $524.81 | $891.25 | $1,148.15 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $338.84 Typical High $489.78 | Professional | None | $151.36 | $338.84 | $489.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $186.21 Median $275.42 Typical High $380.19 | Professional | None | $186.21 | $275.42 | $380.19 |
Oscar Health Setting Professional Modifier None Typical Low $234.42 Median $302.00 Typical High $467.74 | Professional | None | $234.42 | $302.00 | $467.74 |
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 $186.21 Median $302.00 Typical High $575.44 | Professional | None | $186.21 | $302.00 | $575.44 |
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 $75.86 Median $102.33 Typical High $123.03 | Professional | 52 · Reduced service | $75.86 | $102.33 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $40.74 Typical High $48.98 | Professional | 53 · Discontinued | $30.20 | $40.74 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $151.36 Typical High $181.97 | Professional | 54 · Surgery only | $112.20 | $151.36 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $30.90 Typical High $36.31 | Professional | 55 · Aftercare only | $22.91 | $30.90 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $20.42 Typical High $24.55 | Professional | 56 · Pre-op care only | $15.14 | $20.42 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $141.25 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $104.71 | $141.25 | $169.82 |
Where Georgia sits
The same service costs 4.7 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· 22nd of 51
$288
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.