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 $602.56 Median $5,011.87 Typical High $10,000.00 | Facility | None | $602.56 | $5,011.87 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $602.56 Typical High $3,162.28 | Professional | None | $549.54 | $602.56 | $3,162.28 |
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 $537.03 Median $794.33 Typical High $1,318.26 | Professional | None | $537.03 | $794.33 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,513.56 Typical High $2,511.89 | Facility | None | $602.56 | $1,513.56 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $1,096.48 Typical High $1,318.26 | Professional | None | $512.86 | $1,096.48 | $1,318.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $758.58 Typical High $1,230.27 | Professional | None | $676.08 | $758.58 | $1,230.27 |
United Setting Facility Modifier None Typical Low $501.19 Median $724.44 Typical High $3,548.13 | Facility | None | $501.19 | $724.44 | $3,548.13 |
United Setting Professional Modifier None Typical Low $562.34 Median $954.99 Typical High $1,698.24 | Professional | None | $562.34 | $954.99 | $1,698.24 |
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 $275.42 Median $288.40 Typical High $354.81 | Professional | 52 · Reduced service | $275.42 | $288.40 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $114.82 Typical High $141.25 | Professional | 53 · Discontinued | $109.65 | $114.82 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $436.52 Typical High $524.81 | Professional | 54 · Surgery only | $416.87 | $436.52 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $87.10 Typical High $104.71 | Professional | 55 · Aftercare only | $83.18 | $87.10 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $57.54 Typical High $70.79 | Professional | 56 · Pre-op care only | $54.95 | $57.54 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $407.38 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $389.05 | $407.38 | $489.78 |
Where Georgia sits
The same service costs 7.2 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· 24th of 51
$794
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.