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 $41.69 Median $5,370.32 Typical High $7,585.78 | Facility | None | $41.69 | $5,370.32 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $47.86 Typical High $63.10 | Professional | None | $41.69 | $47.86 | $63.10 |
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 $43.65 Median $64.57 Typical High $107.15 | Professional | None | $43.65 | $64.57 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $346.74 Typical High $4,265.80 | Facility | None | $50.12 | $346.74 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $40.74 Median $83.18 Typical High $104.71 | Professional | None | $40.74 | $83.18 | $104.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $46.77 Median $60.26 Typical High $70.79 | Professional | None | $46.77 | $60.26 | $70.79 |
Oscar Health Setting Professional Modifier None Typical Low $61.66 Median $66.07 Typical High $75.86 | Professional | None | $61.66 | $66.07 | $75.86 |
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 $46.77 Median $75.86 Typical High $134.90 | Professional | None | $46.77 | $75.86 | $134.90 |
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 $20.89 Median $22.39 Typical High $27.54 | Professional | 52 · Reduced service | $20.89 | $22.39 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $8.91 Typical High $10.96 | Professional | 53 · Discontinued | $8.32 | $8.91 | $10.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $33.88 Typical High $40.74 | Professional | 54 · Surgery only | $31.62 | $33.88 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $6.76 Typical High $8.13 | Professional | 55 · Aftercare only | $6.31 | $6.76 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.47 Typical High $5.50 | Professional | 56 · Pre-op care only | $4.17 | $4.47 | $5.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $29.51 Median $31.62 Typical High $38.02 | Professional | 78 · Unplanned return to OR | $29.51 | $31.62 | $38.02 |
Where Georgia sits
The same service costs 4.6 times more in Alaska than in New York. 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
$64.57
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.