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 $338.84 Median $4,466.84 Typical High $7,585.78 | Facility | None | $338.84 | $4,466.84 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $380.19 Typical High $1,071.52 | Professional | None | $239.88 | $380.19 | $1,071.52 |
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 $275.42 Median $398.11 Typical High $691.83 | Professional | None | $275.42 | $398.11 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $891.25 Typical High $1,148.15 | Facility | None | $524.81 | $891.25 | $1,148.15 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $537.03 Typical High $776.25 | Professional | None | $245.47 | $537.03 | $776.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $269.15 Median $436.52 Typical High $741.31 | Professional | None | $269.15 | $436.52 | $741.31 |
Oscar Health Setting Professional Modifier None Typical Low $354.81 Median $489.78 Typical High $562.34 | Professional | None | $354.81 | $489.78 | $562.34 |
United Setting Facility Modifier None Typical Low $501.19 Median $724.44 Typical High $3,548.13 | Facility | None | $501.19 | $724.44 | $3,548.13 |
United Setting Professional Modifier None Typical Low $295.12 Median $501.19 Typical High $933.25 | Professional | None | $295.12 | $501.19 | $933.25 |
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 $120.23 Median $165.96 Typical High $204.17 | Professional | 52 · Reduced service | $120.23 | $165.96 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $66.07 Typical High $81.28 | Professional | 53 · Discontinued | $47.86 | $66.07 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $251.19 Typical High $302.00 | Professional | 54 · Surgery only | $181.97 | $251.19 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $50.12 Typical High $60.26 | Professional | 55 · Aftercare only | $36.31 | $50.12 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $33.11 Typical High $40.74 | Professional | 56 · Pre-op care only | $23.99 | $33.11 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $234.42 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $169.82 | $234.42 | $281.84 |
Where Georgia sits
The same service costs 3.9 times more in Alaska than in Utah. 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
$457
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.