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 $56.23 Median $3,548.13 Typical High $7,585.78 | Facility | None | $56.23 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $63.10 Typical High $147.91 | Professional | None | $45.71 | $63.10 | $147.91 |
Ambetter Setting Professional Modifier None Typical Low $58.88 Median $109.65 Typical High $128.82 | Professional | None | $58.88 | $109.65 | $128.82 |
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 $47.86 Median $75.86 Typical High $128.82 | Professional | None | $47.86 | $75.86 | $128.82 |
CareSource Setting Professional Modifier None Typical Low $61.66 Median $66.07 Typical High $72.44 | Professional | None | $61.66 | $66.07 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $346.74 Typical High $4,265.80 | Facility | None | $50.12 | $346.74 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $107.15 Typical High $131.83 | Professional | None | $44.67 | $107.15 | $131.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $53.70 Median $74.13 Typical High $107.15 | Professional | None | $53.70 | $74.13 | $107.15 |
Oscar Health Setting Professional Modifier None Typical Low $69.18 Median $85.11 Typical High $97.72 | Professional | None | $69.18 | $85.11 | $97.72 |
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 $54.95 Median $89.13 Typical High $162.18 | Professional | None | $54.95 | $89.13 | $162.18 |
7 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 $22.91 Median $28.18 Typical High $33.88 | Professional | 52 · Reduced service | $22.91 | $28.18 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $11.22 Typical High $13.49 | Professional | 53 · Discontinued | $9.12 | $11.22 | $13.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $34.67 Median $42.66 Typical High $50.12 | Professional | 54 · Surgery only | $34.67 | $42.66 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $8.51 Typical High $10.00 | Professional | 55 · Aftercare only | $6.92 | $8.51 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $5.62 Typical High $6.76 | Professional | 56 · Pre-op care only | $4.57 | $5.62 | $6.76 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $32.36 Median $39.81 Typical High $46.77 | Professional | 78 · Unplanned return to OR | $32.36 | $39.81 | $46.77 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $57.54 Median $104.71 Typical High $117.49 | Professional | 59 · Distinct service | $57.54 | $104.71 | $117.49 |
Where Georgia sits
The same service costs 4.2 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· 20th of 51
$81.28
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.