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 $112.20 Median $5,370.32 Typical High $7,585.78 | Facility | None | $112.20 | $5,370.32 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $199.53 Typical High $245.47 | Professional | None | $112.20 | $199.53 | $245.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $380.19 Median $776.25 Typical High $3,630.78 | Facility | None | $380.19 | $776.25 | $3,630.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $131.83 Median $223.87 Typical High $380.19 | Professional | None | $131.83 | $223.87 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $346.74 Typical High $4,265.80 | Facility | None | $50.12 | $346.74 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $257.04 Typical High $457.09 | Professional | None | $114.82 | $257.04 | $457.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $131.83 Median $257.04 Typical High $309.03 | Professional | None | $131.83 | $257.04 | $309.03 |
Oscar Health Setting Professional Modifier None Typical Low $169.82 Median $194.98 Typical High $331.13 | Professional | None | $169.82 | $194.98 | $331.13 |
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 $141.25 Median $275.42 Typical High $549.54 | Professional | None | $141.25 | $275.42 | $549.54 |
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 $56.23 Median $95.50 Typical High $120.23 | Professional | 52 · Reduced service | $56.23 | $95.50 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $38.02 Typical High $47.86 | Professional | 53 · Discontinued | $22.39 | $38.02 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $144.54 Typical High $181.97 | Professional | 54 · Surgery only | $85.11 | $144.54 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $28.84 Typical High $36.31 | Professional | 55 · Aftercare only | $16.98 | $28.84 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $19.05 Typical High $23.99 | Professional | 56 · Pre-op care only | $11.22 | $19.05 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $134.90 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $79.43 | $134.90 | $169.82 |
Where Georgia sits
The same service costs 3.8 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
$240
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.