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 $186.21 Median $5,370.32 Typical High $7,585.78 | Facility | None | $186.21 | $5,370.32 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $316.23 Typical High $363.08 | Professional | None | $186.21 | $316.23 | $363.08 |
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 $218.78 Median $354.81 Typical High $588.84 | Professional | None | $218.78 | $354.81 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $316.23 Typical High $4,265.80 | Facility | None | $50.12 | $316.23 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $407.38 Typical High $660.69 | Professional | None | $204.17 | $407.38 | $660.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $213.80 Median $371.54 Typical High $489.78 | Professional | None | $213.80 | $371.54 | $489.78 |
Oscar Health Setting Professional Modifier None Typical Low $269.15 Median $309.03 Typical High $478.63 | Professional | None | $269.15 | $309.03 | $478.63 |
United Setting Facility Modifier None Typical Low $331.13 Median $501.19 Typical High $2,454.71 | Facility | None | $331.13 | $501.19 | $2,454.71 |
United Setting Professional Modifier None Typical Low $245.47 Median $446.68 Typical High $831.76 | Professional | None | $245.47 | $446.68 | $831.76 |
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 $93.33 Median $141.25 Typical High $177.83 | Professional | 52 · Reduced service | $93.33 | $141.25 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $56.23 Typical High $70.79 | Professional | 53 · Discontinued | $37.15 | $56.23 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $208.93 Typical High $269.15 | Professional | 54 · Surgery only | $141.25 | $208.93 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $42.66 Typical High $53.70 | Professional | 55 · Aftercare only | $28.18 | $42.66 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $28.18 Typical High $35.48 | Professional | 56 · Pre-op care only | $18.62 | $28.18 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $194.98 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $131.83 | $194.98 | $251.19 |
Where Georgia sits
The same service costs 4.1 times more in Alaska than in Kentucky. 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
$389
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.