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 $107.15 Median $3,548.13 Typical High $7,585.78 | Facility | None | $107.15 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $141.25 Typical High $380.19 | Professional | None | $85.11 | $141.25 | $380.19 |
Ambetter Setting Professional Modifier None Typical Low $87.10 Median $154.88 Typical High $269.15 | Professional | None | $87.10 | $154.88 | $269.15 |
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 $109.65 Median $186.21 Typical High $281.84 | Professional | None | $109.65 | $186.21 | $281.84 |
CareSource Setting Professional Modifier None Typical Low $144.54 Median $154.88 Typical High $169.82 | Professional | None | $144.54 | $154.88 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $134.90 Typical High $602.56 | Facility | None | $102.33 | $134.90 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $263.03 Typical High $380.19 | Professional | None | $141.25 | $263.03 | $380.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $104.71 Median $177.83 Typical High $371.54 | Professional | None | $104.71 | $177.83 | $371.54 |
Oscar Health Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
United Setting Facility Modifier None Typical Low $79.43 Median $158.49 Typical High $1,778.28 | Facility | None | $79.43 | $158.49 | $1,778.28 |
United Setting Professional Modifier None Typical Low $117.49 Median $229.09 Typical High $380.19 | Professional | None | $117.49 | $229.09 | $380.19 |
7 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 $41.69 Median $60.26 Typical High $69.18 | Professional | 52 · Reduced service | $41.69 | $60.26 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $23.99 Typical High $27.54 | Professional | 53 · Discontinued | $16.98 | $23.99 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $91.20 Typical High $104.71 | Professional | 54 · Surgery only | $63.10 | $91.20 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $18.20 Typical High $20.89 | Professional | 55 · Aftercare only | $12.59 | $18.20 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $12.02 Typical High $13.80 | Professional | 56 · Pre-op care only | $8.51 | $12.02 | $13.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $58.88 Median $85.11 Typical High $97.72 | Professional | 78 · Unplanned return to OR | $58.88 | $85.11 | $97.72 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $162.18 Median $281.84 Typical High $309.03 | Professional | 59 · Distinct service | $162.18 | $281.84 | $309.03 |
Where Georgia sits
The same service costs 3.2 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
$191
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.