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 $239.88 Median $251.19 Typical High $275.42 | Professional | None | $239.88 | $251.19 | $275.42 |
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 $204.17 Median $346.74 Typical High $524.81 | Professional | None | $204.17 | $346.74 | $524.81 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $371.54 Median $524.81 Typical High $851.14 | Professional | 50 · Both sides | $371.54 | $524.81 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $1,000.00 Typical High $1,318.26 | Facility | None | $398.11 | $1,000.00 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $363.08 Typical High $645.65 | Professional | None | $251.19 | $363.08 | $645.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $275.42 Median $331.13 Typical High $489.78 | Professional | None | $275.42 | $331.13 | $489.78 |
Oscar Health Setting Professional Modifier None Typical Low $446.68 Median $467.74 Typical High $512.86 | Professional | None | $446.68 | $467.74 | $512.86 |
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 $208.93 Median $331.13 Typical High $660.69 | Professional | None | $208.93 | $331.13 | $660.69 |
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 $120.23 Median $125.89 Typical High $134.90 | Professional | 52 · Reduced service | $120.23 | $125.89 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $50.12 Typical High $53.70 | Professional | 53 · Discontinued | $47.86 | $50.12 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $186.21 Typical High $204.17 | Professional | 54 · Surgery only | $181.97 | $186.21 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $37.15 Typical High $40.74 | Professional | 55 · Aftercare only | $36.31 | $37.15 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $25.12 Typical High $26.92 | Professional | 56 · Pre-op care only | $23.99 | $25.12 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $173.78 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $169.82 | $173.78 | $190.55 |
Where Georgia sits
The same service costs 5.4 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· 20th of 51
$347
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.