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 $977.24 Median $5,370.32 Typical High $7,943.28 | Facility | None | $977.24 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $630.96 Typical High $954.99 | Professional | None | $616.60 | $630.96 | $954.99 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,548.82 Typical High $10,964.78 | Facility | None | $588.84 | $1,548.82 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $562.34 Median $851.14 Typical High $1,380.38 | Professional | None | $562.34 | $851.14 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,073.80 Typical High $5,128.61 | Facility | None | $602.56 | $4,073.80 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $954.99 Typical High $1,621.81 | Professional | None | $691.83 | $954.99 | $1,621.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $645.65 Median $724.44 Typical High $1,348.96 | Professional | None | $645.65 | $724.44 | $1,348.96 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $7,585.78 | Facility | None | $954.99 | $1,995.26 | $7,585.78 |
United Setting Professional Modifier None Typical Low $549.54 Median $891.25 Typical High $1,659.59 | Professional | None | $549.54 | $891.25 | $1,659.59 |
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 $309.03 Median $316.23 Typical High $346.74 | Professional | 52 · Reduced service | $309.03 | $316.23 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $125.89 Typical High $138.04 | Professional | 53 · Discontinued | $123.03 | $125.89 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $467.74 Typical High $524.81 | Professional | 54 · Surgery only | $467.74 | $467.74 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $104.71 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $63.10 Typical High $69.18 | Professional | 56 · Pre-op care only | $61.66 | $63.10 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $436.52 | $436.52 | $489.78 |
Where Georgia sits
The same service costs 8.1 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· 23rd of 51
$891
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.