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 $1,202.26 Median $5,623.41 Typical High $9,549.93 | Facility | None | $1,202.26 | $5,623.41 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $691.83 | Professional | None | $501.19 | $501.19 | $691.83 |
Ambetter Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | None | $602.56 | $602.56 | $602.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $776.25 Median $1,479.11 Typical High $7,244.36 | Facility | None | $776.25 | $1,479.11 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $436.52 Median $724.44 Typical High $1,148.15 | Professional | None | $436.52 | $724.44 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $323.59 Median $489.78 Typical High $741.31 | Professional | 62 · Two surgeons | $323.59 | $489.78 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $3,467.37 Typical High $4,365.16 | Facility | None | $812.83 | $3,467.37 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $870.96 Typical High $1,288.25 | Professional | None | $630.96 | $870.96 | $1,288.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $501.19 Median $562.34 Typical High $1,995.26 | Professional | None | $501.19 | $562.34 | $1,995.26 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,479.11 Typical High $5,011.87 | Facility | None | $851.14 | $1,479.11 | $5,011.87 |
United Setting Professional Modifier None Typical Low $478.63 Median $776.25 Typical High $1,318.26 | Professional | None | $478.63 | $776.25 | $1,318.26 |
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 $251.19 Median $251.19 Typical High $281.84 | Professional | 52 · Reduced service | $251.19 | $251.19 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $100.00 Typical High $112.20 | Professional | 53 · Discontinued | $100.00 | $100.00 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $380.19 Typical High $416.87 | Professional | 54 · Surgery only | $371.54 | $380.19 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $75.86 Typical High $83.18 | Professional | 55 · Aftercare only | $74.13 | $75.86 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $50.12 Typical High $56.23 | Professional | 56 · Pre-op care only | $50.12 | $50.12 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $354.81 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $346.74 | $354.81 | $389.05 |
Where Georgia sits
The same service costs 18.2 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· 20th of 51
$813
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.