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 $177.83 Median $3,548.13 Typical High $7,585.78 | Facility | None | $177.83 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $190.55 Typical High $549.54 | Professional | None | $109.65 | $190.55 | $549.54 |
Ambetter Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
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 $134.90 Median $199.53 Typical High $346.74 | Professional | None | $134.90 | $199.53 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $158.49 Typical High $446.68 | Facility | None | $114.82 | $158.49 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $251.19 Typical High $407.38 | Professional | None | $114.82 | $251.19 | $407.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $123.03 Median $223.87 Typical High $416.87 | Professional | None | $123.03 | $223.87 | $416.87 |
Oscar Health Setting Professional Modifier None Typical Low $165.96 Median $263.03 Typical High $302.00 | Professional | None | $165.96 | $263.03 | $302.00 |
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 $141.25 Median $245.47 Typical High $478.63 | Professional | None | $141.25 | $245.47 | $478.63 |
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 $54.95 Median $85.11 Typical High $107.15 | Professional | 52 · Reduced service | $54.95 | $85.11 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $33.88 Typical High $42.66 | Professional | 53 · Discontinued | $22.39 | $33.88 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $128.82 Typical High $158.49 | Professional | 54 · Surgery only | $83.18 | $128.82 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $25.70 Typical High $31.62 | Professional | 55 · Aftercare only | $16.60 | $25.70 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $16.98 Typical High $21.38 | Professional | 56 · Pre-op care only | $10.96 | $16.98 | $21.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $120.23 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $77.62 | $120.23 | $147.91 |
Where Georgia sits
The same service costs 3.5 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· 20th of 51
$214
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.