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 $177.83 Median $3,548.13 Typical High $7,585.78 | Facility | None | $177.83 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $269.15 Typical High $630.96 | Professional | None | $162.18 | $269.15 | $630.96 |
Ambetter Setting Professional Modifier None Typical Low $144.54 Median $269.15 Typical High $467.74 | Professional | None | $144.54 | $269.15 | $467.74 |
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 $186.21 Median $275.42 Typical High $489.78 | Professional | None | $186.21 | $275.42 | $489.78 |
CareSource Setting Professional Modifier None Typical Low $251.19 Median $269.15 Typical High $302.00 | Professional | None | $251.19 | $269.15 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $229.09 Typical High $602.56 | Facility | None | $173.78 | $229.09 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $371.54 Typical High $549.54 | Professional | None | $165.96 | $371.54 | $549.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $181.97 Median $309.03 Typical High $446.68 | Professional | None | $181.97 | $309.03 | $446.68 |
Oscar Health Setting Professional Modifier None Typical Low $245.47 Median $354.81 Typical High $398.11 | Professional | None | $245.47 | $354.81 | $398.11 |
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 $199.53 Median $338.84 Typical High $660.69 | Professional | None | $199.53 | $338.84 | $660.69 |
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 $81.28 Median $114.82 Typical High $144.54 | Professional | 52 · Reduced service | $81.28 | $114.82 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $45.71 Typical High $57.54 | Professional | 53 · Discontinued | $33.11 | $45.71 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $173.78 Typical High $218.78 | Professional | 54 · Surgery only | $123.03 | $173.78 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $34.67 Typical High $43.65 | Professional | 55 · Aftercare only | $24.55 | $34.67 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $22.91 Typical High $28.84 | Professional | 56 · Pre-op care only | $16.22 | $22.91 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $162.18 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $114.82 | $162.18 | $204.17 |
Where Georgia sits
The same service costs 3.6 times more in Alaska than in Texas. 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
$302
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.