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 $676.08 Median $5,370.32 Typical High $7,762.47 | Facility | None | $676.08 | $5,370.32 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $776.25 Typical High $2,137.96 | Professional | None | $562.34 | $776.25 | $2,137.96 |
Ambetter Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
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 $645.65 Median $870.96 Typical High $1,548.82 | Professional | None | $645.65 | $870.96 | $1,548.82 |
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 $549.54 Median $1,202.26 Typical High $1,584.89 | Professional | None | $549.54 | $1,202.26 | $1,584.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $630.96 Median $891.25 Typical High $1,258.93 | Professional | None | $630.96 | $891.25 | $1,258.93 |
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 $676.08 Median $1,047.13 Typical High $1,995.26 | Professional | None | $676.08 | $1,047.13 | $1,995.26 |
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 $281.84 Median $338.84 Typical High $407.38 | Professional | 52 · Reduced service | $281.84 | $338.84 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $134.90 Typical High $165.96 | Professional | 53 · Discontinued | $112.20 | $134.90 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $512.86 Typical High $616.60 | Professional | 54 · Surgery only | $416.87 | $512.86 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $102.33 Typical High $123.03 | Professional | 55 · Aftercare only | $83.18 | $102.33 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $67.61 Typical High $81.28 | Professional | 56 · Pre-op care only | $56.23 | $67.61 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $478.63 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $389.05 | $478.63 | $575.44 |
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· 26th of 51
$891
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.