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 $204.17 Median $3,630.78 Typical High $7,585.78 | Facility | None | $204.17 | $3,630.78 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $363.08 Typical High $977.24 | Professional | None | $186.21 | $363.08 | $977.24 |
Ambetter Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $478.63 Median $851.14 Typical High $3,630.78 | Facility | None | $478.63 | $851.14 | $3,630.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $218.78 Median $354.81 Typical High $616.60 | Professional | None | $218.78 | $354.81 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $302.00 Typical High $794.33 | Facility | None | $223.87 | $302.00 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $501.19 Typical High $870.96 | Professional | None | $251.19 | $501.19 | $870.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $223.87 Median $436.52 Typical High $630.96 | Professional | None | $223.87 | $436.52 | $630.96 |
Oscar Health Setting Professional Modifier None Typical Low $281.84 Median $478.63 Typical High $549.54 | Professional | None | $281.84 | $478.63 | $549.54 |
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 $234.42 Median $426.58 Typical High $933.25 | Professional | None | $234.42 | $426.58 | $933.25 |
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 $93.33 Median $154.88 Typical High $199.53 | Professional | 52 · Reduced service | $93.33 | $154.88 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $63.10 Typical High $79.43 | Professional | 53 · Discontinued | $37.15 | $63.10 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $239.88 Typical High $302.00 | Professional | 54 · Surgery only | $138.04 | $239.88 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $46.77 Typical High $60.26 | Professional | 55 · Aftercare only | $28.18 | $46.77 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $30.90 Typical High $39.81 | Professional | 56 · Pre-op care only | $18.62 | $30.90 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $218.78 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $128.82 | $218.78 | $281.84 |
Where Georgia sits
The same service costs 3.5 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· 20th of 51
$380
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.