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 $407.38 Median $3,548.13 Typical High $7,585.78 | Facility | None | $407.38 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $398.11 Typical High $446.68 | Professional | None | $363.08 | $398.11 | $446.68 |
Anthem BCBS Setting Facility Modifier None Typical Low $380.19 Median $776.25 Typical High $3,630.78 | Facility | None | $380.19 | $776.25 | $3,630.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $309.03 Median $524.81 Typical High $812.83 | Professional | None | $309.03 | $524.81 | $812.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $562.34 Median $776.25 Typical High $1,288.25 | Professional | 50 · Both sides | $562.34 | $776.25 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $181.97 Typical High $602.56 | Facility | None | $134.90 | $181.97 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $602.56 Typical High $1,023.29 | Professional | None | $398.11 | $602.56 | $1,023.29 |
Kaiser Permanente Setting Professional Modifier None Typical Low $436.52 Median $524.81 Typical High $794.33 | Professional | None | $436.52 | $524.81 | $794.33 |
Oscar Health Setting Professional Modifier None Typical Low $691.83 Median $741.31 Typical High $851.14 | Professional | None | $691.83 | $741.31 | $851.14 |
United Setting Facility Modifier None Typical Low $79.43 Median $158.49 Typical High $1,778.28 | Facility | None | $79.43 | $158.49 | $1,778.28 |
United Setting Professional Modifier None Typical Low $323.59 Median $537.03 Typical High $1,023.29 | Professional | None | $323.59 | $537.03 | $1,023.29 |
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 $181.97 Median $199.53 Typical High $213.80 | Professional | 52 · Reduced service | $181.97 | $199.53 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $79.43 Typical High $85.11 | Professional | 53 · Discontinued | $72.44 | $79.43 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $302.00 Typical High $323.59 | Professional | 54 · Surgery only | $275.42 | $302.00 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $60.26 Typical High $64.57 | Professional | 55 · Aftercare only | $54.95 | $60.26 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $39.81 Typical High $42.66 | Professional | 56 · Pre-op care only | $36.31 | $39.81 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $281.84 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $257.04 | $281.84 | $302.00 |
Where Georgia sits
The same service costs 5.2 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
$501
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.