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 $109.65 Median $3,548.13 Typical High $7,585.78 | Facility | None | $109.65 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $141.25 Typical High $371.54 | Professional | None | $75.86 | $141.25 | $371.54 |
Ambetter Setting Professional Modifier None Typical Low $151.36 Median $316.23 Typical High $316.23 | Professional | None | $151.36 | $316.23 | $316.23 |
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 $74.13 Median $138.04 Typical High $257.04 | Professional | None | $74.13 | $138.04 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $346.74 Typical High $4,265.80 | Facility | None | $50.12 | $346.74 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $208.93 Typical High $380.19 | Professional | None | $107.15 | $208.93 | $380.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $100.00 Median $141.25 Typical High $194.98 | Professional | None | $100.00 | $141.25 | $194.98 |
Oscar Health Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
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 $95.50 Median $173.78 Typical High $389.05 | Professional | None | $95.50 | $173.78 | $389.05 |
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 $38.02 Median $54.95 Typical High $70.79 | Professional | 52 · Reduced service | $38.02 | $54.95 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $21.88 Typical High $28.18 | Professional | 53 · Discontinued | $15.49 | $21.88 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $83.18 Typical High $107.15 | Professional | 54 · Surgery only | $57.54 | $83.18 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $16.60 Typical High $21.38 | Professional | 55 · Aftercare only | $11.48 | $16.60 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $10.72 Typical High $14.13 | Professional | 56 · Pre-op care only | $7.59 | $10.72 | $14.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $53.70 Median $77.62 Typical High $100.00 | Professional | 78 · Unplanned return to OR | $53.70 | $77.62 | $100.00 |
Where Georgia sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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
$162
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.