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 $151.36 Median $4,168.69 Typical High $7,585.78 | Facility | None | $151.36 | $4,168.69 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $223.87 Typical High $549.54 | Professional | None | $151.36 | $223.87 | $549.54 |
Ambetter Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $831.76 Typical High $4,570.88 | Facility | None | $389.05 | $831.76 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $147.91 Median $263.03 Typical High $426.58 | Professional | None | $147.91 | $263.03 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $213.80 Typical High $602.56 | Facility | None | $158.49 | $213.80 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $263.03 Typical High $489.78 | Professional | None | $165.96 | $263.03 | $489.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $165.96 Median $269.15 Typical High $371.54 | Professional | None | $165.96 | $269.15 | $371.54 |
Oscar Health Setting Professional Modifier None Typical Low $229.09 Median $331.13 Typical High $436.52 | Professional | None | $229.09 | $331.13 | $436.52 |
United Setting Facility Modifier None Typical Low $331.13 Median $501.19 Typical High $2,454.71 | Facility | None | $331.13 | $501.19 | $2,454.71 |
United Setting Professional Modifier None Typical Low $151.36 Median $263.03 Typical High $512.86 | Professional | None | $151.36 | $263.03 | $512.86 |
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 $75.86 Median $97.72 Typical High $117.49 | Professional | 52 · Reduced service | $75.86 | $97.72 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $38.90 Typical High $46.77 | Professional | 53 · Discontinued | $30.20 | $38.90 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $144.54 Typical High $173.78 | Professional | 54 · Surgery only | $112.20 | $144.54 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $28.84 Typical High $34.67 | Professional | 55 · Aftercare only | $22.91 | $28.84 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $19.50 Typical High $23.44 | Professional | 56 · Pre-op care only | $15.14 | $19.50 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $134.90 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $104.71 | $134.90 | $162.18 |
Where Georgia sits
The same service costs 3.5 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
$263
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.