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 $794.33 Median $5,370.32 Typical High $7,585.78 | Facility | None | $794.33 | $5,370.32 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $891.25 Typical High $2,137.96 | Professional | None | $645.65 | $891.25 | $2,137.96 |
Ambetter Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,288.25 | Professional | None | $1,202.26 | $1,202.26 | $1,288.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $562.34 Median $1,071.52 Typical High $4,570.88 | Facility | None | $562.34 | $1,071.52 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $758.58 Median $1,047.13 Typical High $1,737.80 | Professional | None | $758.58 | $1,047.13 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,318.26 Typical High $1,819.70 | Facility | None | $602.56 | $1,318.26 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $1,445.44 Typical High $1,862.09 | Professional | None | $645.65 | $1,445.44 | $1,862.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $741.31 Median $1,047.13 Typical High $1,778.28 | Professional | None | $741.31 | $1,047.13 | $1,778.28 |
Oscar Health Setting Professional Modifier None Typical Low $977.24 Median $1,174.90 Typical High $1,348.96 | Professional | None | $977.24 | $1,174.90 | $1,348.96 |
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 $794.33 Median $1,258.93 Typical High $2,290.87 | Professional | None | $794.33 | $1,258.93 | $2,290.87 |
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 $323.59 Median $398.11 Typical High $478.63 | Professional | 52 · Reduced service | $323.59 | $398.11 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $158.49 Typical High $190.55 | Professional | 53 · Discontinued | $128.82 | $158.49 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $588.84 Typical High $707.95 | Professional | 54 · Surgery only | $489.78 | $588.84 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $117.49 Typical High $141.25 | Professional | 55 · Aftercare only | $97.72 | $117.49 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $79.43 Typical High $95.50 | Professional | 56 · Pre-op care only | $64.57 | $79.43 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $549.54 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $457.09 | $549.54 | $660.69 |
Where Georgia sits
The same service costs 4.4 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· 24th of 51
$1,047
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.