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 $758.58 Median $5,370.32 Typical High $11,481.54 | Facility | None | $758.58 | $5,370.32 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $1,621.81 Typical High $1,819.70 | Professional | None | $758.58 | $1,621.81 | $1,819.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $1,698.24 Typical High $7,244.36 | Facility | None | $954.99 | $1,698.24 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $660.69 Median $1,148.15 Typical High $1,737.80 | Professional | None | $660.69 | $1,148.15 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $1,122.02 Median $3,467.37 Typical High $4,677.35 | Facility | None | $1,122.02 | $3,467.37 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,862.09 Typical High $3,630.78 | Professional | None | $933.25 | $1,862.09 | $3,630.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $794.33 Median $1,862.09 Typical High $2,754.23 | Professional | None | $794.33 | $1,862.09 | $2,754.23 |
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 $776.25 Median $1,698.24 Typical High $3,801.89 | Professional | None | $776.25 | $1,698.24 | $3,801.89 |
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 $380.19 Median $758.58 Typical High $912.01 | Professional | 52 · Reduced service | $380.19 | $758.58 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $302.00 Typical High $363.08 | Professional | 53 · Discontinued | $154.88 | $302.00 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $1,122.02 Typical High $1,380.38 | Professional | 54 · Surgery only | $575.44 | $1,122.02 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $223.87 Typical High $275.42 | Professional | 55 · Aftercare only | $114.82 | $223.87 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $151.36 Typical High $181.97 | Professional | 56 · Pre-op care only | $75.86 | $151.36 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $1,047.13 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $537.03 | $1,047.13 | $1,288.25 |
Where Georgia sits
The same service costs 4.9 times more in Alaska than in Texas. 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· 38th of 51
$1,413
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.