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 $309.03 Median $4,897.79 Typical High $7,943.28 | Facility | None | $309.03 | $4,897.79 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $309.03 Typical High $380.19 | Professional | None | $229.09 | $309.03 | $380.19 |
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 $269.15 Median $380.19 Typical High $645.65 | Professional | None | $269.15 | $380.19 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $234.42 Typical High $512.86 | Facility | None | $165.96 | $234.42 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $512.86 Typical High $691.83 | Professional | None | $239.88 | $512.86 | $691.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $251.19 Median $398.11 Typical High $812.83 | Professional | None | $251.19 | $398.11 | $812.83 |
Oscar Health Setting Professional Modifier None Typical Low $346.74 Median $446.68 Typical High $512.86 | Professional | None | $346.74 | $446.68 | $512.86 |
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 $281.84 Median $457.09 Typical High $851.14 | Professional | None | $281.84 | $457.09 | $851.14 |
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 $114.82 Median $154.88 Typical High $186.21 | Professional | 52 · Reduced service | $114.82 | $154.88 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $61.66 Typical High $74.13 | Professional | 53 · Discontinued | $45.71 | $61.66 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $229.09 Typical High $275.42 | Professional | 54 · Surgery only | $173.78 | $229.09 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $45.71 Typical High $54.95 | Professional | 55 · Aftercare only | $34.67 | $45.71 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $30.90 Typical High $37.15 | Professional | 56 · Pre-op care only | $22.91 | $30.90 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $213.80 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $162.18 | $213.80 | $257.04 |
Where Georgia sits
The same service costs 4.0 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
$389
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.