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 $851.14 Median $5,370.32 Typical High $7,585.78 | Facility | None | $851.14 | $5,370.32 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $977.24 Typical High $2,238.72 | Professional | None | $691.83 | $977.24 | $2,238.72 |
Ambetter Setting Professional Modifier None Typical Low $676.08 Median $1,819.70 Typical High $1,819.70 | Professional | None | $676.08 | $1,819.70 | $1,819.70 |
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 $812.83 Median $1,122.02 Typical High $1,862.09 | Professional | None | $812.83 | $1,122.02 | $1,862.09 |
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 $691.83 Median $1,548.82 Typical High $1,995.26 | Professional | None | $691.83 | $1,548.82 | $1,995.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $776.25 Median $1,122.02 Typical High $2,089.30 | Professional | None | $776.25 | $1,122.02 | $2,089.30 |
Oscar Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,258.93 Typical High $1,445.44 | Professional | None | $1,047.13 | $1,258.93 | $1,445.44 |
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 $851.14 Median $1,348.96 Typical High $2,511.89 | Professional | None | $851.14 | $1,348.96 | $2,511.89 |
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 $346.74 Median $426.58 Typical High $512.86 | Professional | 52 · Reduced service | $346.74 | $426.58 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $169.82 Typical High $204.17 | Professional | 53 · Discontinued | $138.04 | $169.82 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $630.96 Typical High $758.58 | Professional | 54 · Surgery only | $524.81 | $630.96 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $128.82 Typical High $154.88 | Professional | 55 · Aftercare only | $104.71 | $128.82 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $85.11 Typical High $102.33 | Professional | 56 · Pre-op care only | $69.18 | $85.11 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $588.84 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $489.78 | $588.84 | $707.95 |
Where Georgia sits
The same service costs 4.5 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· 23rd of 51
$1,122
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.