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 $295.12 Median $3,548.13 Typical High $7,585.78 | Facility | None | $295.12 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $323.59 Typical High $912.01 | Professional | None | $234.42 | $323.59 | $912.01 |
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 $275.42 Median $380.19 Typical High $660.69 | Professional | None | $275.42 | $380.19 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $275.42 Typical High $645.65 | Facility | None | $208.93 | $275.42 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $512.86 Typical High $676.08 | Professional | None | $229.09 | $512.86 | $676.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $269.15 Median $380.19 Typical High $616.60 | Professional | None | $269.15 | $380.19 | $616.60 |
Oscar Health Setting Professional Modifier None Typical Low $354.81 Median $436.52 Typical High $501.19 | Professional | None | $354.81 | $436.52 | $501.19 |
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 $281.84 Median $467.74 Typical High $851.14 | Professional | None | $281.84 | $467.74 | $851.14 |
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 $117.49 Median $147.91 Typical High $173.78 | Professional | 52 · Reduced service | $117.49 | $147.91 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $58.88 Typical High $70.79 | Professional | 53 · Discontinued | $46.77 | $58.88 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $218.78 Typical High $263.03 | Professional | 54 · Surgery only | $173.78 | $218.78 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $43.65 Typical High $52.48 | Professional | 55 · Aftercare only | $34.67 | $43.65 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $29.51 Typical High $35.48 | Professional | 56 · Pre-op care only | $23.44 | $29.51 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $204.17 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $162.18 | $204.17 | $245.47 |
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· 22nd 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.