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 $134.90 Median $3,548.13 Typical High $7,585.78 | Facility | None | $134.90 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $251.19 Typical High $602.56 | Professional | None | $125.89 | $251.19 | $602.56 |
Ambetter Setting Professional Modifier None Typical Low $251.19 Median $446.68 Typical High $512.86 | Professional | None | $251.19 | $446.68 | $512.86 |
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 $151.36 Median $245.47 Typical High $407.38 | Professional | None | $151.36 | $245.47 | $407.38 |
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 $169.82 Median $331.13 Typical High $602.56 | Professional | None | $169.82 | $331.13 | $602.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $144.54 Median $295.12 Typical High $316.23 | Professional | None | $144.54 | $295.12 | $316.23 |
Oscar Health Setting Professional Modifier None Typical Low $186.21 Median $331.13 Typical High $380.19 | Professional | None | $186.21 | $331.13 | $380.19 |
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 $158.49 Median $288.40 Typical High $630.96 | Professional | None | $158.49 | $288.40 | $630.96 |
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 $61.66 Median $109.65 Typical High $128.82 | Professional | 52 · Reduced service | $61.66 | $109.65 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $43.65 Typical High $51.29 | Professional | 53 · Discontinued | $24.55 | $43.65 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $162.18 Typical High $190.55 | Professional | 54 · Surgery only | $93.33 | $162.18 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $32.36 Typical High $38.02 | Professional | 55 · Aftercare only | $18.62 | $32.36 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $21.88 Typical High $25.70 | Professional | 56 · Pre-op care only | $12.30 | $21.88 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $151.36 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $87.10 | $151.36 | $177.83 |
Where Georgia sits
The same service costs 3.4 times more in Alaska than in Maryland. 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· 18th of 51
$263
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.