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 $831.76 Median $4,466.84 Typical High $7,585.78 | Facility | None | $831.76 | $4,466.84 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $812.83 Typical High $1,000.00 | Professional | None | $691.83 | $812.83 | $1,000.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $512.86 Median $1,174.90 Typical High $7,244.36 | Facility | None | $512.86 | $1,174.90 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $575.44 Median $912.01 Typical High $1,548.82 | Professional | None | $575.44 | $912.01 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $3,388.44 Typical High $4,265.80 | Facility | None | $524.81 | $3,388.44 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,230.27 Typical High $1,778.28 | Professional | None | $831.76 | $1,230.27 | $1,778.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $724.44 Median $1,047.13 Typical High $1,778.28 | Professional | None | $724.44 | $1,047.13 | $1,778.28 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $2,884.03 Typical High $8,709.64 | Facility | None | $1,258.93 | $2,884.03 | $8,709.64 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,202.26 Typical High $1,949.84 | Professional | None | $724.44 | $1,202.26 | $1,949.84 |
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 $338.84 Median $398.11 Typical High $436.52 | Professional | 52 · Reduced service | $338.84 | $398.11 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $162.18 Typical High $173.78 | Professional | 53 · Discontinued | $138.04 | $162.18 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $602.56 Typical High $645.65 | Professional | 54 · Surgery only | $512.86 | $602.56 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $120.23 Typical High $131.83 | Professional | 55 · Aftercare only | $102.33 | $120.23 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $79.43 Typical High $87.10 | Professional | 56 · Pre-op care only | $69.18 | $79.43 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $562.34 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $478.63 | $562.34 | $602.56 |
Where Georgia sits
The same service costs 5.8 times more in Alaska than in Utah. 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· 24th of 51
$1,023
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.