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 $85.11 Median $3,548.13 Typical High $7,585.78 | Facility | None | $85.11 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $93.33 Typical High $223.87 | Professional | None | $60.26 | $93.33 | $223.87 |
Ambetter Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $87.10 | Professional | None | $45.71 | $45.71 | $87.10 |
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 $69.18 Median $100.00 Typical High $173.78 | Professional | None | $69.18 | $100.00 | $173.78 |
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 $60.26 Median $134.90 Typical High $194.98 | Professional | None | $60.26 | $134.90 | $194.98 |
Kaiser Permanente Setting Professional Modifier None Typical Low $66.07 Median $107.15 Typical High $190.55 | Professional | None | $66.07 | $107.15 | $190.55 |
Oscar Health Setting Professional Modifier None Typical Low $89.13 Median $125.89 Typical High $144.54 | Professional | None | $89.13 | $125.89 | $144.54 |
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 $72.44 Median $123.03 Typical High $229.09 | Professional | None | $72.44 | $123.03 | $229.09 |
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 $30.20 Median $41.69 Typical High $50.12 | Professional | 52 · Reduced service | $30.20 | $41.69 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $16.60 Typical High $20.42 | Professional | 53 · Discontinued | $12.02 | $16.60 | $20.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $63.10 Typical High $75.86 | Professional | 54 · Surgery only | $44.67 | $63.10 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $12.59 Typical High $15.14 | Professional | 55 · Aftercare only | $8.91 | $12.59 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $8.32 Typical High $10.23 | Professional | 56 · Pre-op care only | $6.03 | $8.32 | $10.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $41.69 Median $58.88 Typical High $70.79 | Professional | 78 · Unplanned return to OR | $41.69 | $58.88 | $70.79 |
Where Georgia sits
The same service costs 3.8 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· 22nd of 51
$107
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.