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 $173.78 Median $3,548.13 Typical High $7,585.78 | Facility | None | $173.78 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $223.87 Typical High $524.81 | Professional | None | $151.36 | $223.87 | $524.81 |
Ambetter Setting Professional Modifier None Typical Low $147.91 Median $223.87 Typical High $295.12 | Professional | None | $147.91 | $223.87 | $295.12 |
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 $426.58 | Professional | None | $173.78 | $251.19 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $190.55 Typical High $602.56 | Facility | None | $144.54 | $190.55 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $338.84 Typical High $457.09 | Professional | None | $147.91 | $338.84 | $457.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $177.83 Median $257.04 Typical High $380.19 | Professional | None | $177.83 | $257.04 | $380.19 |
Oscar Health Setting Professional Modifier None Typical Low $229.09 Median $288.40 Typical High $436.52 | Professional | None | $229.09 | $288.40 | $436.52 |
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 $181.97 Median $288.40 Typical High $562.34 | Professional | None | $181.97 | $288.40 | $562.34 |
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 $97.72 Typical High $117.49 | Professional | 52 · Reduced service | $75.86 | $97.72 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $38.90 Typical High $47.86 | Professional | 53 · Discontinued | $30.20 | $38.90 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $147.91 Typical High $177.83 | Professional | 54 · Surgery only | $114.82 | $147.91 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $29.51 Typical High $35.48 | Professional | 55 · Aftercare only | $22.91 | $29.51 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $19.50 Typical High $23.44 | Professional | 56 · Pre-op care only | $15.14 | $19.50 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $138.04 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $107.15 | $138.04 | $165.96 |
Where Georgia sits
The same service costs 3.9 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· 19th 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.