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 $245.47 Median $3,548.13 Typical High $7,585.78 | Facility | None | $245.47 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $275.42 Typical High $758.58 | Professional | None | $190.55 | $275.42 | $758.58 |
Ambetter Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $186.21 | Professional | None | $147.91 | $147.91 | $186.21 |
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 $223.87 Median $316.23 Typical High $549.54 | Professional | None | $223.87 | $316.23 | $549.54 |
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 $190.55 Median $426.58 Typical High $575.44 | Professional | None | $190.55 | $426.58 | $575.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $223.87 Median $323.59 Typical High $457.09 | Professional | None | $223.87 | $323.59 | $457.09 |
Oscar Health Setting Professional Modifier None Typical Low $288.40 Median $363.08 Typical High $549.54 | Professional | None | $288.40 | $363.08 | $549.54 |
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 $234.42 Median $371.54 Typical High $707.95 | Professional | None | $234.42 | $371.54 | $707.95 |
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 $95.50 Median $123.03 Typical High $147.91 | Professional | 52 · Reduced service | $95.50 | $123.03 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $48.98 Typical High $58.88 | Professional | 53 · Discontinued | $38.90 | $48.98 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $181.97 Typical High $223.87 | Professional | 54 · Surgery only | $144.54 | $181.97 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $36.31 Typical High $44.67 | Professional | 55 · Aftercare only | $28.84 | $36.31 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $24.55 Typical High $29.51 | Professional | 56 · Pre-op care only | $19.05 | $24.55 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $169.82 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $134.90 | $169.82 | $208.93 |
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· 20th of 51
$347
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.