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 $208.93 Median $3,548.13 Typical High $7,585.78 | Facility | None | $208.93 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $229.09 Typical High $660.69 | Professional | None | $141.25 | $229.09 | $660.69 |
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 $169.82 Median $234.42 Typical High $426.58 | Professional | None | $169.82 | $234.42 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $194.98 Typical High $602.56 | Facility | None | $144.54 | $194.98 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $323.59 Typical High $478.63 | Professional | None | $147.91 | $323.59 | $478.63 |
Kaiser Permanente Setting Professional Modifier None Typical Low $154.88 Median $269.15 Typical High $537.03 | Professional | None | $154.88 | $269.15 | $537.03 |
Oscar Health Setting Professional Modifier None Typical Low $213.80 Median $309.03 Typical High $354.81 | Professional | None | $213.80 | $309.03 | $354.81 |
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 $177.83 Median $302.00 Typical High $562.34 | Professional | None | $177.83 | $302.00 | $562.34 |
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 $70.79 Median $102.33 Typical High $125.89 | Professional | 52 · Reduced service | $70.79 | $102.33 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $40.74 Typical High $50.12 | Professional | 53 · Discontinued | $28.18 | $40.74 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $151.36 Typical High $190.55 | Professional | 54 · Surgery only | $107.15 | $151.36 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $30.20 Typical High $38.02 | Professional | 55 · Aftercare only | $21.38 | $30.20 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $20.42 Typical High $25.12 | Professional | 56 · Pre-op care only | $14.13 | $20.42 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $141.25 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $100.00 | $141.25 | $177.83 |
Where Georgia sits
The same service costs 3.5 times more in Alaska than in Texas. 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· 23rd of 51
$251
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.