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 $165.96 Median $257.04 Typical High $295.12 | Professional | None | $165.96 | $257.04 | $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 $141.25 Median $229.09 Typical High $398.11 | Professional | None | $141.25 | $229.09 | $398.11 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $257.04 Median $354.81 Typical High $602.56 | Professional | 50 · Both sides | $257.04 | $354.81 | $602.56 |
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 $190.55 Median $316.23 Typical High $588.84 | Professional | None | $190.55 | $316.23 | $588.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $173.78 Median $302.00 Typical High $436.52 | Professional | None | $173.78 | $302.00 | $436.52 |
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 $169.82 Median $302.00 Typical High $602.56 | Professional | None | $169.82 | $302.00 | $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 $83.18 Median $117.49 Typical High $141.25 | Professional | 52 · Reduced service | $83.18 | $117.49 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $46.77 Typical High $56.23 | Professional | 53 · Discontinued | $33.88 | $46.77 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $173.78 Typical High $213.80 | Professional | 54 · Surgery only | $125.89 | $173.78 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $34.67 Typical High $42.66 | Professional | 55 · Aftercare only | $25.12 | $34.67 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $23.44 Typical High $28.18 | Professional | 56 · Pre-op care only | $16.60 | $23.44 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $162.18 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $117.49 | $162.18 | $199.53 |
Where Georgia sits
The same service costs 3.7 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· 23rd of 51
$275
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.