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 $398.11 Median $3,548.13 Typical High $7,585.78 | Facility | None | $398.11 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $398.11 Typical High $954.99 | Professional | None | $363.08 | $398.11 | $954.99 |
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 $302.00 Median $512.86 Typical High $776.25 | Professional | None | $302.00 | $512.86 | $776.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $549.54 Median $758.58 Typical High $1,230.27 | Professional | 50 · Both sides | $549.54 | $758.58 | $1,230.27 |
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 $575.44 Typical High $1,000.00 | Professional | None | $398.11 | $575.44 | $1,000.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $426.58 Median $524.81 Typical High $776.25 | Professional | None | $426.58 | $524.81 | $776.25 |
Oscar Health Setting Professional Modifier None Typical Low $676.08 Median $707.95 Typical High $831.76 | Professional | None | $676.08 | $707.95 | $831.76 |
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 $512.86 Typical High $1,000.00 | Professional | None | $323.59 | $512.86 | $1,000.00 |
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 $177.83 Median $194.98 Typical High $208.93 | Professional | 52 · Reduced service | $177.83 | $194.98 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $77.62 Typical High $83.18 | Professional | 53 · Discontinued | $70.79 | $77.62 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $288.40 Typical High $309.03 | Professional | 54 · Surgery only | $263.03 | $288.40 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $57.54 Typical High $61.66 | Professional | 55 · Aftercare only | $53.70 | $57.54 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $38.90 Typical High $41.69 | Professional | 56 · Pre-op care only | $35.48 | $38.90 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $269.15 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $251.19 | $269.15 | $288.40 |
Where Georgia sits
The same service costs 5.1 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· 18th of 51
$513
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.