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 $144.54 Median $3,548.13 Typical High $7,585.78 | Facility | None | $144.54 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $154.88 Typical High $380.19 | Professional | None | $89.13 | $154.88 | $380.19 |
Ambetter Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
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 $104.71 Median $162.18 Typical High $288.40 | Professional | None | $104.71 | $162.18 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $93.33 Median $128.82 Typical High $363.08 | Facility | None | $93.33 | $128.82 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $204.17 Typical High $323.59 | Professional | None | $93.33 | $204.17 | $323.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $100.00 Median $181.97 Typical High $295.12 | Professional | None | $100.00 | $181.97 | $295.12 |
Oscar Health Setting Professional Modifier None Typical Low $134.90 Median $208.93 Typical High $239.88 | Professional | None | $134.90 | $208.93 | $239.88 |
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 $112.20 Median $194.98 Typical High $389.05 | Professional | None | $112.20 | $194.98 | $389.05 |
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 $44.67 Median $69.18 Typical High $85.11 | Professional | 52 · Reduced service | $44.67 | $69.18 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $27.54 Typical High $33.88 | Professional | 53 · Discontinued | $17.78 | $27.54 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $102.33 Typical High $128.82 | Professional | 54 · Surgery only | $67.61 | $102.33 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $20.42 Typical High $25.70 | Professional | 55 · Aftercare only | $13.49 | $20.42 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $13.80 Typical High $16.98 | Professional | 56 · Pre-op care only | $8.91 | $13.80 | $16.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $63.10 Median $95.50 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $63.10 | $95.50 | $120.23 |
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
$174
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.