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 $234.42 Median $3,548.13 Typical High $7,585.78 | Facility | None | $234.42 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $389.05 Typical High $741.31 | Professional | None | $147.91 | $389.05 | $741.31 |
Ambetter Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $436.52 | Professional | None | $338.84 | $338.84 | $436.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $851.14 Typical High $4,570.88 | Facility | None | $389.05 | $851.14 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $134.90 Median $204.17 Typical High $380.19 | Professional | None | $134.90 | $204.17 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $851.14 Typical High $1,122.02 | Facility | None | $398.11 | $851.14 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $389.05 Typical High $794.33 | Professional | None | $165.96 | $389.05 | $794.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $165.96 Median $416.87 Typical High $724.44 | Professional | None | $165.96 | $416.87 | $724.44 |
Oscar Health Setting Professional Modifier None Typical Low $223.87 Median $338.84 Typical High $724.44 | Professional | None | $223.87 | $338.84 | $724.44 |
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 $151.36 Median $380.19 Typical High $851.14 | Professional | None | $151.36 | $380.19 | $851.14 |
7 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 $74.13 Median $158.49 Typical High $199.53 | Professional | 52 · Reduced service | $74.13 | $158.49 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $63.10 Typical High $79.43 | Professional | 53 · Discontinued | $29.51 | $63.10 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $234.42 Typical High $302.00 | Professional | 54 · Surgery only | $112.20 | $234.42 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $46.77 Typical High $60.26 | Professional | 55 · Aftercare only | $22.39 | $46.77 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $31.62 Typical High $39.81 | Professional | 56 · Pre-op care only | $14.79 | $31.62 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $218.78 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $104.71 | $218.78 | $281.84 |
Ambetter Setting Professional Modifier 58 · Staged procedure Typical Low $331.13 Median $457.09 Typical High $457.09 | Professional | 58 · Staged procedure | $331.13 | $457.09 | $457.09 |
Where Georgia sits
The same service costs 4.0 times more in Alaska than in Kentucky. 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· 46th of 51
$269
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.