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 $302.00 Median $5,370.32 Typical High $7,585.78 | Facility | None | $302.00 | $5,370.32 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $416.87 Typical High $1,071.52 | Professional | None | $302.00 | $416.87 | $1,071.52 |
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 $331.13 Median $501.19 Typical High $891.25 | Professional | None | $331.13 | $501.19 | $891.25 |
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 $302.00 Median $676.08 Typical High $933.25 | Professional | None | $302.00 | $676.08 | $933.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $354.81 Median $524.81 Typical High $575.44 | Professional | None | $354.81 | $524.81 | $575.44 |
Oscar Health Setting Professional Modifier None Typical Low $457.09 Median $524.81 Typical High $691.83 | Professional | None | $457.09 | $524.81 | $691.83 |
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 $363.08 Median $588.84 Typical High $1,122.02 | Professional | None | $363.08 | $588.84 | $1,122.02 |
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 $151.36 Median $199.53 Typical High $229.09 | Professional | 52 · Reduced service | $151.36 | $199.53 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $81.28 Typical High $91.20 | Professional | 53 · Discontinued | $60.26 | $81.28 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $302.00 Typical High $346.74 | Professional | 54 · Surgery only | $223.87 | $302.00 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $60.26 Typical High $69.18 | Professional | 55 · Aftercare only | $44.67 | $60.26 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $40.74 Typical High $45.71 | Professional | 56 · Pre-op care only | $30.20 | $40.74 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $281.84 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $208.93 | $281.84 | $323.59 |
Where Georgia sits
The same service costs 4.7 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· 21st of 51
$501
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.