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 $213.80 Median $4,168.69 Typical High $7,585.78 | Facility | None | $213.80 | $4,168.69 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $302.00 Typical High $724.44 | Professional | None | $194.98 | $302.00 | $724.44 |
Ambetter Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None | $616.60 | $616.60 | $616.60 |
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 $223.87 Median $323.59 Typical High $562.34 | Professional | None | $223.87 | $323.59 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $257.04 Typical High $645.65 | Facility | None | $190.55 | $257.04 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $436.52 Typical High $630.96 | Professional | None | $194.98 | $436.52 | $630.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $218.78 Median $354.81 Typical High $602.56 | Professional | None | $218.78 | $354.81 | $602.56 |
Oscar Health Setting Professional Modifier None Typical Low $288.40 Median $398.11 Typical High $457.09 | Professional | None | $288.40 | $398.11 | $457.09 |
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 $398.11 Typical High $758.58 | Professional | None | $234.42 | $398.11 | $758.58 |
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 $97.72 Median $131.83 Typical High $165.96 | Professional | 52 · Reduced service | $97.72 | $131.83 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $53.70 Typical High $66.07 | Professional | 53 · Discontinued | $38.90 | $53.70 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $199.53 Typical High $245.47 | Professional | 54 · Surgery only | $144.54 | $199.53 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $39.81 Typical High $48.98 | Professional | 55 · Aftercare only | $28.84 | $39.81 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $26.92 Typical High $33.11 | Professional | 56 · Pre-op care only | $19.50 | $26.92 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $186.21 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $134.90 | $186.21 | $229.09 |
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· 20th of 51
$363
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.