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 $125.89 Median $4,897.79 Typical High $7,943.28 | Facility | None | $125.89 | $4,897.79 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $134.90 Typical High $331.13 | Professional | None | $89.13 | $134.90 | $331.13 |
Ambetter Setting Professional Modifier None Typical Low $194.98 Median $245.47 Typical High $245.47 | Professional | None | $194.98 | $245.47 | $245.47 |
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 $100.00 Median $147.91 Typical High $263.03 | Professional | None | $100.00 | $147.91 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $104.71 Median $138.04 Typical High $602.56 | Facility | None | $104.71 | $138.04 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $190.55 Typical High $281.84 | Professional | None | $85.11 | $190.55 | $281.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $109.65 Median $158.49 Typical High $186.21 | Professional | None | $109.65 | $158.49 | $186.21 |
Oscar Health Setting Professional Modifier None Typical Low $134.90 Median $177.83 Typical High $263.03 | Professional | None | $134.90 | $177.83 | $263.03 |
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 $107.15 Median $177.83 Typical High $338.84 | Professional | None | $107.15 | $177.83 | $338.84 |
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 $44.67 Median $60.26 Typical High $72.44 | Professional | 52 · Reduced service | $44.67 | $60.26 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $23.99 Typical High $28.84 | Professional | 53 · Discontinued | $17.78 | $23.99 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $91.20 Typical High $109.65 | Professional | 54 · Surgery only | $66.07 | $91.20 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $18.20 Typical High $21.88 | Professional | 55 · Aftercare only | $13.49 | $18.20 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $12.02 Typical High $14.45 | Professional | 56 · Pre-op care only | $8.91 | $12.02 | $14.45 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $61.66 Median $85.11 Typical High $102.33 | Professional | 78 · Unplanned return to OR | $61.66 | $85.11 | $102.33 |
Where Georgia sits
The same service costs 4.1 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· 21st of 51
$166
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.