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 $3,630.78 Typical High $7,585.78 | Facility | None | $851.14 | $3,630.78 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $977.24 Typical High $2,344.23 | Professional | None | $724.44 | $977.24 | $2,344.23 |
Ambetter Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,819.70 | Professional | None | $1,698.24 | $1,698.24 | $1,819.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $512.86 Median $1,000.00 Typical High $4,570.88 | Facility | None | $512.86 | $1,000.00 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $812.83 Median $1,148.15 Typical High $1,905.46 | Professional | None | $812.83 | $1,148.15 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,288.25 Typical High $1,737.80 | Facility | None | $524.81 | $1,288.25 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $1,548.82 Typical High $1,995.26 | Professional | None | $707.95 | $1,548.82 | $1,995.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $812.83 Median $1,122.02 Typical High $1,621.81 | Professional | None | $812.83 | $1,122.02 | $1,621.81 |
Oscar Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,258.93 Typical High $1,479.11 | Professional | None | $1,071.52 | $1,258.93 | $1,479.11 |
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 $831.76 Median $1,318.26 Typical High $2,511.89 | Professional | None | $831.76 | $1,318.26 | $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 $354.81 Median $426.58 Typical High $512.86 | Professional | 52 · Reduced service | $354.81 | $426.58 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $169.82 Typical High $204.17 | Professional | 53 · Discontinued | $144.54 | $169.82 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $645.65 Typical High $776.25 | Professional | 54 · Surgery only | $537.03 | $645.65 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $128.82 Typical High $154.88 | Professional | 55 · Aftercare only | $107.15 | $128.82 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $85.11 Typical High $102.33 | Professional | 56 · Pre-op care only | $72.44 | $85.11 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $602.56 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $501.19 | $602.56 | $724.44 |
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· 22nd of 51
$1,148
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.