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 $794.33 Median $5,370.32 Typical High $7,943.28 | Facility | None | $794.33 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $912.01 Typical High $2,570.40 | Professional | None | $794.33 | $912.01 | $2,570.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $1,148.15 Typical High $5,754.40 | Facility | None | $575.44 | $1,148.15 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $794.33 Median $1,174.90 Typical High $1,949.84 | Professional | None | $794.33 | $1,174.90 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,445.44 Typical High $1,995.26 | Facility | None | $602.56 | $1,445.44 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,698.24 Typical High $1,862.09 | Professional | None | $776.25 | $1,698.24 | $1,862.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $954.99 Median $1,071.52 Typical High $1,949.84 | Professional | None | $954.99 | $1,071.52 | $1,949.84 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,479.11 Typical High $5,011.87 | Facility | None | $851.14 | $1,479.11 | $5,011.87 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,380.38 Typical High $2,398.83 | Professional | None | $851.14 | $1,380.38 | $2,398.83 |
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 $398.11 Median $416.87 Typical High $501.19 | Professional | 52 · Reduced service | $398.11 | $416.87 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $165.96 Typical High $204.17 | Professional | 53 · Discontinued | $158.49 | $165.96 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $616.60 Typical High $758.58 | Professional | 54 · Surgery only | $602.56 | $616.60 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $123.03 Typical High $151.36 | Professional | 55 · Aftercare only | $120.23 | $123.03 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $83.18 Typical High $100.00 | Professional | 56 · Pre-op care only | $79.43 | $83.18 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $575.44 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $562.34 | $575.44 | $707.95 |
Where Georgia sits
The same service costs 7.1 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· 22nd of 51
$1,230
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.