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 $165.96 Median $3,548.13 Typical High $7,585.78 | Facility | None | $165.96 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $181.97 Typical High $436.52 | Professional | None | $102.33 | $181.97 | $436.52 |
Ambetter Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $338.84 | Professional | None | $169.82 | $169.82 | $338.84 |
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 $123.03 Median $190.55 Typical High $331.13 | Professional | None | $123.03 | $190.55 | $331.13 |
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 $107.15 Median $234.42 Typical High $380.19 | Professional | None | $107.15 | $234.42 | $380.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $114.82 Median $208.93 Typical High $371.54 | Professional | None | $114.82 | $208.93 | $371.54 |
Oscar Health Setting Professional Modifier None Typical Low $154.88 Median $239.88 Typical High $275.42 | Professional | None | $154.88 | $239.88 | $275.42 |
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 $131.83 Median $229.09 Typical High $446.68 | Professional | None | $131.83 | $229.09 | $446.68 |
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 $51.29 Median $79.43 Typical High $100.00 | Professional | 52 · Reduced service | $51.29 | $79.43 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $31.62 Typical High $39.81 | Professional | 53 · Discontinued | $20.89 | $31.62 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $120.23 Typical High $147.91 | Professional | 54 · Surgery only | $77.62 | $120.23 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $23.99 Typical High $29.51 | Professional | 55 · Aftercare only | $15.49 | $23.99 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $15.85 Typical High $19.95 | Professional | 56 · Pre-op care only | $10.23 | $15.85 | $19.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $112.20 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $72.44 | $112.20 | $138.04 |
Where Georgia sits
The same service costs 3.3 times more in Alaska than in Maryland. 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· 21st of 51
$204
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.