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 $239.88 Median $3,548.13 Typical High $7,585.78 | Facility | None | $239.88 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $251.19 Typical High $295.12 | Professional | None | $158.49 | $251.19 | $295.12 |
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 $213.80 Typical High $346.74 | Professional | None | $128.82 | $213.80 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $245.47 Typical High $630.96 | Facility | None | $186.21 | $245.47 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $309.03 Typical High $575.44 | Professional | None | $181.97 | $309.03 | $575.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $165.96 Median $295.12 Typical High $426.58 | Professional | None | $165.96 | $295.12 | $426.58 |
United Setting Facility Modifier None Typical Low $331.13 Median $501.19 Typical High $2,454.71 | Facility | None | $331.13 | $501.19 | $2,454.71 |
United Setting Professional Modifier None Typical Low $162.18 Median $295.12 Typical High $602.56 | Professional | None | $162.18 | $295.12 | $602.56 |
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 $117.49 Typical High $141.25 | Professional | 52 · Reduced service | $79.43 | $117.49 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $46.77 Typical High $56.23 | Professional | 53 · Discontinued | $31.62 | $46.77 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $173.78 Typical High $213.80 | Professional | 54 · Surgery only | $120.23 | $173.78 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $35.48 Typical High $42.66 | Professional | 55 · Aftercare only | $23.99 | $35.48 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $23.44 Typical High $28.18 | Professional | 56 · Pre-op care only | $15.85 | $23.44 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $162.18 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $112.20 | $162.18 | $199.53 |
Where Georgia sits
The same service costs 4.4 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
$263
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.