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 $93.33 Median $3,548.13 Typical High $7,585.78 | Facility | None | $93.33 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $162.18 Typical High $446.68 | Professional | None | $93.33 | $162.18 | $446.68 |
Ambetter Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
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 $112.20 Median $181.97 Typical High $302.00 | Professional | None | $112.20 | $181.97 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $154.88 Typical High $436.52 | Facility | None | $112.20 | $154.88 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $251.19 Typical High $416.87 | Professional | None | $134.90 | $251.19 | $416.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $117.49 Median $208.93 Typical High $245.47 | Professional | None | $117.49 | $208.93 | $245.47 |
Oscar Health Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
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 $125.89 Median $223.87 Typical High $446.68 | Professional | None | $125.89 | $223.87 | $446.68 |
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 $46.77 Median $64.57 Typical High $83.18 | Professional | 52 · Reduced service | $46.77 | $64.57 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $25.70 Typical High $33.11 | Professional | 53 · Discontinued | $19.05 | $25.70 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $97.72 Typical High $125.89 | Professional | 54 · Surgery only | $70.79 | $97.72 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $19.50 Typical High $25.12 | Professional | 55 · Aftercare only | $14.13 | $19.50 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $12.88 Typical High $16.60 | Professional | 56 · Pre-op care only | $9.33 | $12.88 | $16.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $66.07 Median $91.20 Typical High $117.49 | Professional | 78 · Unplanned return to OR | $66.07 | $91.20 | $117.49 |
Where Georgia sits
The same service costs 3.5 times more in Alaska than in Florida. 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· 26th of 51
$195
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.