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 $158.49 Median $3,548.13 Typical High $7,585.78 | Facility | None | $158.49 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $239.88 Typical High $575.44 | Professional | None | $144.54 | $239.88 | $575.44 |
Ambetter Setting Professional Modifier None Typical Low $117.49 Median $234.42 Typical High $245.47 | Professional | None | $117.49 | $234.42 | $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 $162.18 Median $251.19 Typical High $436.52 | Professional | None | $162.18 | $251.19 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $218.78 Typical High $602.56 | Facility | None | $162.18 | $218.78 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $323.59 Typical High $501.19 | Professional | None | $144.54 | $323.59 | $501.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $162.18 Median $281.84 Typical High $426.58 | Professional | None | $162.18 | $281.84 | $426.58 |
Oscar Health Setting Professional Modifier None Typical Low $213.80 Median $316.23 Typical High $363.08 | Professional | None | $213.80 | $316.23 | $363.08 |
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 $173.78 Median $302.00 Typical High $588.84 | Professional | None | $173.78 | $302.00 | $588.84 |
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 $72.44 Median $104.71 Typical High $131.83 | Professional | 52 · Reduced service | $72.44 | $104.71 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $41.69 Typical High $52.48 | Professional | 53 · Discontinued | $28.84 | $41.69 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $154.88 Typical High $194.98 | Professional | 54 · Surgery only | $107.15 | $154.88 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $30.90 Typical High $38.90 | Professional | 55 · Aftercare only | $21.38 | $30.90 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $20.89 Typical High $26.30 | Professional | 56 · Pre-op care only | $14.45 | $20.89 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $144.54 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $100.00 | $144.54 | $181.97 |
Where Georgia sits
The same service costs 3.4 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
$275
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.