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 $269.15 Median $3,548.13 Typical High $7,585.78 | Facility | None | $269.15 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $281.84 Typical High $707.95 | Professional | None | $269.15 | $281.84 | $707.95 |
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 $223.87 Median $380.19 Typical High $562.34 | Professional | None | $223.87 | $380.19 | $562.34 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $398.11 Median $562.34 Typical High $912.01 | Professional | 50 · Both sides | $398.11 | $562.34 | $912.01 |
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 $288.40 Median $407.38 Typical High $724.44 | Professional | None | $288.40 | $407.38 | $724.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $316.23 Median $380.19 Typical High $549.54 | Professional | None | $316.23 | $380.19 | $549.54 |
Oscar Health Setting Professional Modifier None Typical Low $501.19 Median $512.86 Typical High $588.84 | Professional | None | $501.19 | $512.86 | $588.84 |
United Setting Facility Modifier None Typical Low $79.43 Median $158.49 Typical High $1,905.46 | Facility | None | $79.43 | $158.49 | $1,905.46 |
United Setting Professional Modifier None Typical Low $234.42 Median $380.19 Typical High $724.44 | Professional | None | $234.42 | $380.19 | $724.44 |
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 $131.83 Median $141.25 Typical High $151.36 | Professional | 52 · Reduced service | $131.83 | $141.25 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $56.23 Typical High $60.26 | Professional | 53 · Discontinued | $52.48 | $56.23 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $208.93 Typical High $229.09 | Professional | 54 · Surgery only | $194.98 | $208.93 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $41.69 Typical High $45.71 | Professional | 55 · Aftercare only | $38.90 | $41.69 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $28.18 Typical High $30.20 | Professional | 56 · Pre-op care only | $26.30 | $28.18 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $194.98 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $181.97 | $194.98 | $213.80 |
Where Georgia sits
The same service costs 5.9 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· 16th of 51
$380
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.