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 $229.09 Median $3,630.78 Typical High $7,413.10 | Facility | None | $229.09 | $3,630.78 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $380.19 Typical High $891.25 | Professional | None | $208.93 | $380.19 | $891.25 |
Ambetter Setting Professional Modifier None Typical Low $389.05 Median $741.31 Typical High $741.31 | Professional | None | $389.05 | $741.31 | $741.31 |
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 $251.19 Median $380.19 Typical High $676.08 | Professional | None | $251.19 | $380.19 | $676.08 |
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 $288.40 Median $549.54 Typical High $870.96 | Professional | None | $288.40 | $549.54 | $870.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $229.09 Median $426.58 Typical High $549.54 | Professional | None | $229.09 | $426.58 | $549.54 |
Oscar Health Setting Professional Modifier None Typical Low $309.03 Median $489.78 Typical High $562.34 | Professional | None | $309.03 | $489.78 | $562.34 |
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 $263.03 Median $467.74 Typical High $912.01 | Professional | None | $263.03 | $467.74 | $912.01 |
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 $102.33 Median $162.18 Typical High $204.17 | Professional | 52 · Reduced service | $102.33 | $162.18 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $64.57 Typical High $81.28 | Professional | 53 · Discontinued | $41.69 | $64.57 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $239.88 Typical High $302.00 | Professional | 54 · Surgery only | $154.88 | $239.88 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $47.86 Typical High $60.26 | Professional | 55 · Aftercare only | $30.90 | $47.86 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $32.36 Typical High $40.74 | Professional | 56 · Pre-op care only | $20.89 | $32.36 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $223.87 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $144.54 | $223.87 | $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· 19th of 51
$398
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.