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 $794.33 Median $4,466.84 Typical High $7,585.78 | Facility | None | $794.33 | $4,466.84 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $707.95 Typical High $831.76 | Professional | None | $478.63 | $707.95 | $831.76 |
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 $323.59 Median $602.56 Typical High $977.24 | Professional | None | $323.59 | $602.56 | $977.24 |
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 $457.09 Median $794.33 Typical High $1,621.81 | Professional | None | $457.09 | $794.33 | $1,621.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $537.03 Median $851.14 Typical High $1,288.25 | Professional | None | $537.03 | $851.14 | $1,288.25 |
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 $380.19 Median $794.33 Typical High $1,698.24 | Professional | None | $380.19 | $794.33 | $1,698.24 |
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 $229.09 Median $323.59 Typical High $407.38 | Professional | 52 · Reduced service | $229.09 | $323.59 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $128.82 Typical High $162.18 | Professional | 53 · Discontinued | $91.20 | $128.82 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $478.63 Typical High $602.56 | Professional | 54 · Surgery only | $346.74 | $478.63 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $95.50 Typical High $120.23 | Professional | 55 · Aftercare only | $69.18 | $95.50 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $64.57 Typical High $81.28 | Professional | 56 · Pre-op care only | $45.71 | $64.57 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $446.68 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $323.59 | $446.68 | $562.34 |
Where Georgia sits
The same service costs 5.9 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· 36th of 51
$631
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.