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 $112.20 Median $3,548.13 Typical High $7,585.78 | Facility | None | $112.20 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $117.49 Typical High $208.93 | Professional | None | $79.43 | $117.49 | $208.93 |
Ambetter Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
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 $77.62 Median $112.20 Typical High $177.83 | Professional | None | $77.62 | $112.20 | $177.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $128.82 Median $169.82 Typical High $269.15 | Professional | 50 · Both sides | $128.82 | $169.82 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $120.23 Typical High $660.69 | Facility | None | $89.13 | $120.23 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $141.25 Typical High $263.03 | Professional | None | $87.10 | $141.25 | $263.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $87.10 Median $138.04 Typical High $602.56 | Professional | None | $87.10 | $138.04 | $602.56 |
Oscar Health Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
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 $79.43 Median $144.54 Typical High $275.42 | Professional | None | $79.43 | $144.54 | $275.42 |
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 $39.81 Median $50.12 Typical High $60.26 | Professional | 52 · Reduced service | $39.81 | $50.12 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $19.95 Typical High $23.99 | Professional | 53 · Discontinued | $15.85 | $19.95 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $74.13 Typical High $91.20 | Professional | 54 · Surgery only | $60.26 | $74.13 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $14.79 Typical High $18.20 | Professional | 55 · Aftercare only | $12.02 | $14.79 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $10.00 Typical High $12.02 | Professional | 56 · Pre-op care only | $7.94 | $10.00 | $12.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $56.23 Median $69.18 Typical High $85.11 | Professional | 78 · Unplanned return to OR | $56.23 | $69.18 | $85.11 |
Where Georgia sits
The same service costs 3.7 times more in Alaska than in Kentucky. 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· 27th of 51
$123
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.