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 $251.19 Median $4,897.79 Typical High $7,943.28 | Facility | None | $251.19 | $4,897.79 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $245.47 Typical High $302.00 | Professional | None | $158.49 | $245.47 | $302.00 |
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 $186.21 Median $275.42 Typical High $489.78 | Professional | None | $186.21 | $275.42 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $229.09 Typical High $512.86 | Facility | None | $162.18 | $229.09 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $426.58 Typical High $660.69 | Professional | None | $213.80 | $426.58 | $660.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $194.98 Median $331.13 Typical High $501.19 | Professional | None | $194.98 | $331.13 | $501.19 |
Oscar Health Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | None | $426.58 | $426.58 | $426.58 |
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 $208.93 Median $346.74 Typical High $707.95 | Professional | None | $208.93 | $346.74 | $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 $79.43 Median $107.15 Typical High $128.82 | Professional | 52 · Reduced service | $79.43 | $107.15 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $42.66 Typical High $51.29 | Professional | 53 · Discontinued | $31.62 | $42.66 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $162.18 Typical High $190.55 | Professional | 54 · Surgery only | $117.49 | $162.18 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $32.36 Typical High $38.02 | Professional | 55 · Aftercare only | $23.44 | $32.36 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $21.38 Typical High $25.70 | Professional | 56 · Pre-op care only | $15.85 | $21.38 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $151.36 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $109.65 | $151.36 | $177.83 |
Where Georgia sits
The same service costs 3.5 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· 23rd of 51
$309
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.