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 $338.84 Median $3,548.13 Typical High $7,585.78 | Facility | None | $338.84 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $338.84 Typical High $812.83 | Professional | None | $309.03 | $338.84 | $812.83 |
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 $263.03 Median $436.52 Typical High $676.08 | Professional | None | $263.03 | $436.52 | $676.08 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $467.74 Median $645.65 Typical High $1,071.52 | Professional | 50 · Both sides | $467.74 | $645.65 | $1,071.52 |
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 $338.84 Median $489.78 Typical High $851.14 | Professional | None | $338.84 | $489.78 | $851.14 |
Kaiser Permanente Setting Professional Modifier None Typical Low $363.08 Median $446.68 Typical High $660.69 | Professional | None | $363.08 | $446.68 | $660.69 |
Oscar Health Setting Professional Modifier None Typical Low $588.84 Median $602.56 Typical High $707.95 | Professional | None | $588.84 | $602.56 | $707.95 |
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 $275.42 Median $436.52 Typical High $851.14 | Professional | None | $275.42 | $436.52 | $851.14 |
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 $151.36 Median $165.96 Typical High $177.83 | Professional | 52 · Reduced service | $151.36 | $165.96 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $66.07 Typical High $70.79 | Professional | 53 · Discontinued | $60.26 | $66.07 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $245.47 Typical High $263.03 | Professional | 54 · Surgery only | $229.09 | $245.47 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $48.98 Typical High $52.48 | Professional | 55 · Aftercare only | $45.71 | $48.98 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $33.11 Typical High $35.48 | Professional | 56 · Pre-op care only | $30.20 | $33.11 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $229.09 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $213.80 | $229.09 | $245.47 |
Where Georgia sits
The same service costs 5.8 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· 19th of 51
$437
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.