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 $128.82 Median $3,548.13 Typical High $7,585.78 | Facility | None | $128.82 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $141.25 Typical High $338.84 | Professional | None | $81.28 | $141.25 | $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 $95.50 Median $147.91 Typical High $251.19 | Professional | None | $95.50 | $147.91 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $120.23 Typical High $346.74 | Facility | None | $85.11 | $120.23 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $186.21 Typical High $295.12 | Professional | None | $83.18 | $186.21 | $295.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $91.20 Median $165.96 Typical High $245.47 | Professional | None | $91.20 | $165.96 | $245.47 |
Oscar Health Setting Professional Modifier None Typical Low $123.03 Median $190.55 Typical High $218.78 | Professional | None | $123.03 | $190.55 | $218.78 |
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 $102.33 Median $177.83 Typical High $346.74 | Professional | None | $102.33 | $177.83 | $346.74 |
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 $40.74 Median $61.66 Typical High $75.86 | Professional | 52 · Reduced service | $40.74 | $61.66 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $24.55 Typical High $30.90 | Professional | 53 · Discontinued | $16.22 | $24.55 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $93.33 Typical High $114.82 | Professional | 54 · Surgery only | $60.26 | $93.33 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $18.62 Typical High $22.91 | Professional | 55 · Aftercare only | $12.02 | $18.62 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $12.30 Typical High $15.14 | Professional | 56 · Pre-op care only | $8.13 | $12.30 | $15.14 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $56.23 Median $87.10 Typical High $107.15 | Professional | 78 · Unplanned return to OR | $56.23 | $87.10 | $107.15 |
Where Georgia sits
The same service costs 3.5 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· 21st of 51
$155
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.