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 $251.19 Median $3,548.13 Typical High $7,585.78 | Facility | None | $251.19 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $281.84 Typical High $524.81 | Professional | None | $158.49 | $281.84 | $524.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $831.76 Typical High $4,570.88 | Facility | None | $389.05 | $831.76 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $128.82 Median $218.78 Typical High $354.81 | Professional | None | $128.82 | $218.78 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $851.14 Typical High $1,122.02 | Facility | None | $398.11 | $851.14 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $309.03 Typical High $602.56 | Professional | None | $177.83 | $309.03 | $602.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $169.82 Median $302.00 Typical High $446.68 | Professional | None | $169.82 | $302.00 | $446.68 |
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 $162.18 Median $295.12 Typical High $616.60 | Professional | None | $162.18 | $295.12 | $616.60 |
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 $79.43 Median $120.23 Typical High $144.54 | Professional | 52 · Reduced service | $79.43 | $120.23 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $47.86 Typical High $57.54 | Professional | 53 · Discontinued | $31.62 | $47.86 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $181.97 Typical High $218.78 | Professional | 54 · Surgery only | $120.23 | $181.97 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $36.31 Typical High $43.65 | Professional | 55 · Aftercare only | $23.99 | $36.31 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $23.99 Typical High $28.84 | Professional | 56 · Pre-op care only | $15.85 | $23.99 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $169.82 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $112.20 | $169.82 | $204.17 |
Where Georgia sits
The same service costs 4.5 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· 27th of 51
$269
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.