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 $204.17 Median $3,548.13 Typical High $7,585.78 | Facility | None | $204.17 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $281.84 Typical High $676.08 | Professional | None | $177.83 | $281.84 | $676.08 |
Ambetter Setting Professional Modifier None Typical Low $190.55 Median $263.03 Typical High $263.03 | Professional | None | $190.55 | $263.03 | $263.03 |
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 $204.17 Median $295.12 Typical High $512.86 | Professional | None | $204.17 | $295.12 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $229.09 Typical High $602.56 | Facility | None | $158.49 | $229.09 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $398.11 Typical High $588.84 | Professional | None | $181.97 | $398.11 | $588.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $199.53 Median $331.13 Typical High $512.86 | Professional | None | $199.53 | $331.13 | $512.86 |
Oscar Health Setting Professional Modifier None Typical Low $263.03 Median $371.54 Typical High $426.58 | Professional | None | $263.03 | $371.54 | $426.58 |
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 $218.78 Median $363.08 Typical High $707.95 | Professional | None | $218.78 | $363.08 | $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 $89.13 Median $123.03 Typical High $154.88 | Professional | 52 · Reduced service | $89.13 | $123.03 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $48.98 Typical High $61.66 | Professional | 53 · Discontinued | $35.48 | $48.98 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $186.21 Typical High $229.09 | Professional | 54 · Surgery only | $134.90 | $186.21 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $37.15 Typical High $45.71 | Professional | 55 · Aftercare only | $26.92 | $37.15 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $24.55 Typical High $30.90 | Professional | 56 · Pre-op care only | $17.78 | $24.55 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $173.78 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $125.89 | $173.78 | $213.80 |
Where Georgia sits
The same service costs 3.9 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· 22nd of 51
$324
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.