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 $117.49 Median $3,548.13 Typical High $7,585.78 | Facility | None | $117.49 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $123.03 Typical High $269.15 | Professional | None | $89.13 | $123.03 | $269.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $512.86 Median $1,000.00 Typical High $4,570.88 | Facility | None | $512.86 | $1,000.00 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $102.33 Median $144.54 Typical High $275.42 | Professional | None | $102.33 | $144.54 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $74.13 Median $100.00 Typical High $288.40 | Facility | None | $74.13 | $100.00 | $288.40 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $158.49 Typical High $275.42 | Professional | None | $97.72 | $158.49 | $275.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $97.72 Median $147.91 Typical High $389.05 | Professional | None | $97.72 | $147.91 | $389.05 |
United Setting Facility Modifier None Typical Low $501.19 Median $724.44 Typical High $3,548.13 | Facility | None | $501.19 | $724.44 | $3,548.13 |
United Setting Professional Modifier None Typical Low $89.13 Median $158.49 Typical High $295.12 | Professional | None | $89.13 | $158.49 | $295.12 |
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 $54.95 Typical High $64.57 | Professional | 52 · Reduced service | $44.67 | $54.95 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $21.88 Typical High $25.70 | Professional | 53 · Discontinued | $17.78 | $21.88 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $83.18 Typical High $95.50 | Professional | 54 · Surgery only | $67.61 | $83.18 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $16.60 Typical High $19.05 | Professional | 55 · Aftercare only | $13.49 | $16.60 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $10.96 Typical High $12.88 | Professional | 56 · Pre-op care only | $8.91 | $10.96 | $12.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $63.10 Median $77.62 Typical High $89.13 | Professional | 78 · Unplanned return to OR | $63.10 | $77.62 | $89.13 |
Where Georgia sits
The same service costs 4.0 times more in Alaska than in Florida. 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· 19th of 51
$148
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.