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 $457.09 Median $5,370.32 Typical High $7,762.47 | Facility | None | $457.09 | $5,370.32 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $436.52 Typical High $489.78 | Professional | None | $331.13 | $436.52 | $489.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $562.34 Median $1,071.52 Typical High $4,570.88 | Facility | None | $562.34 | $1,071.52 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $275.42 Median $457.09 Typical High $724.44 | Professional | None | $275.42 | $457.09 | $724.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $501.19 Median $691.83 Typical High $1,122.02 | Professional | 50 · Both sides | $501.19 | $691.83 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,698.24 Typical High $2,290.87 | Facility | None | $602.56 | $1,698.24 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $562.34 Typical High $1,023.29 | Professional | None | $363.08 | $562.34 | $1,023.29 |
Kaiser Permanente Setting Professional Modifier None Typical Low $346.74 Median $524.81 Typical High $741.31 | Professional | None | $346.74 | $524.81 | $741.31 |
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 $331.13 Median $575.44 Typical High $1,023.29 | Professional | None | $331.13 | $575.44 | $1,023.29 |
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 $165.96 Median $208.93 Typical High $239.88 | Professional | 52 · Reduced service | $165.96 | $208.93 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $83.18 Typical High $95.50 | Professional | 53 · Discontinued | $66.07 | $83.18 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $309.03 Typical High $354.81 | Professional | 54 · Surgery only | $251.19 | $309.03 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $61.66 Typical High $70.79 | Professional | 55 · Aftercare only | $50.12 | $61.66 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $41.69 Typical High $47.86 | Professional | 56 · Pre-op care only | $33.11 | $41.69 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $288.40 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $234.42 | $288.40 | $331.13 |
Where Georgia sits
The same service costs 5.0 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· 28th of 51
$490
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.