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 $346.74 Median $5,370.32 Typical High $7,585.78 | Facility | None | $346.74 | $5,370.32 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $457.09 Typical High $575.44 | Professional | None | $346.74 | $457.09 | $575.44 |
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 $407.38 Median $575.44 Typical High $1,000.00 | Professional | None | $407.38 | $575.44 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $426.58 Typical High $575.44 | Facility | None | $302.00 | $426.58 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $794.33 Typical High $1,047.13 | Professional | None | $346.74 | $794.33 | $1,047.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $398.11 Median $588.84 Typical High $1,318.26 | Professional | None | $398.11 | $588.84 | $1,318.26 |
Oscar Health Setting Professional Modifier None Typical Low $524.81 Median $602.56 Typical High $776.25 | Professional | None | $524.81 | $602.56 | $776.25 |
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 $416.87 Median $707.95 Typical High $1,258.93 | Professional | None | $416.87 | $707.95 | $1,258.93 |
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 $173.78 Median $229.09 Typical High $275.42 | Professional | 52 · Reduced service | $173.78 | $229.09 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $91.20 Typical High $109.65 | Professional | 53 · Discontinued | $69.18 | $91.20 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $338.84 Typical High $407.38 | Professional | 54 · Surgery only | $263.03 | $338.84 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $67.61 Typical High $83.18 | Professional | 55 · Aftercare only | $52.48 | $67.61 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $45.71 Typical High $54.95 | Professional | 56 · Pre-op care only | $34.67 | $45.71 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $316.23 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $245.47 | $316.23 | $380.19 |
Where Georgia sits
The same service costs 5.1 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· 17th of 51
$575
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.