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 $295.12 Median $3,548.13 Typical High $7,585.78 | Facility | None | $295.12 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $316.23 Typical High $776.25 | Professional | None | $295.12 | $316.23 | $776.25 |
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 $245.47 Median $407.38 Typical High $630.96 | Professional | None | $245.47 | $407.38 | $630.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $436.52 Median $616.60 Typical High $1,000.00 | Professional | 50 · Both sides | $436.52 | $616.60 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $165.96 Typical High $457.09 | Facility | None | $117.49 | $165.96 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $467.74 Typical High $812.83 | Professional | None | $323.59 | $467.74 | $812.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $338.84 Median $416.87 Typical High $616.60 | Professional | None | $338.84 | $416.87 | $616.60 |
Oscar Health Setting Professional Modifier None Typical Low $549.54 Median $575.44 Typical High $660.69 | Professional | None | $549.54 | $575.44 | $660.69 |
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 $257.04 Median $416.87 Typical High $794.33 | Professional | None | $257.04 | $416.87 | $794.33 |
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 $144.54 Median $154.88 Typical High $165.96 | Professional | 52 · Reduced service | $144.54 | $154.88 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $61.66 Typical High $66.07 | Professional | 53 · Discontinued | $57.54 | $61.66 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $234.42 Typical High $251.19 | Professional | 54 · Surgery only | $213.80 | $234.42 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $46.77 Typical High $50.12 | Professional | 55 · Aftercare only | $43.65 | $46.77 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $30.90 Typical High $33.11 | Professional | 56 · Pre-op care only | $28.84 | $30.90 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $218.78 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $199.53 | $218.78 | $234.42 |
Where Georgia sits
The same service costs 5.8 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· 18th of 51
$407
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.