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 $323.59 Median $5,370.32 Typical High $7,762.47 | Facility | None | $323.59 | $5,370.32 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $323.59 Typical High $851.14 | Professional | None | $288.40 | $323.59 | $851.14 |
Ambetter Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $562.34 Median $1,071.52 Typical High $4,570.88 | Facility | None | $562.34 | $1,071.52 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $257.04 Median $389.05 Typical High $707.95 | Professional | None | $257.04 | $389.05 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,023.29 Typical High $1,380.38 | Facility | None | $602.56 | $1,023.29 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $489.78 Typical High $741.31 | Professional | None | $323.59 | $489.78 | $741.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $309.03 Median $398.11 Typical High $575.44 | Professional | None | $309.03 | $398.11 | $575.44 |
Oscar Health Setting Professional Modifier None Typical Low $436.52 Median $489.78 Typical High $549.54 | Professional | None | $436.52 | $489.78 | $549.54 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,479.11 Typical High $5,011.87 | Facility | None | $851.14 | $1,479.11 | $5,011.87 |
United Setting Professional Modifier None Typical Low $275.42 Median $457.09 Typical High $758.58 | Professional | None | $275.42 | $457.09 | $758.58 |
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 $141.25 Median $158.49 Typical High $169.82 | Professional | 52 · Reduced service | $141.25 | $158.49 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $64.57 Typical High $69.18 | Professional | 53 · Discontinued | $57.54 | $64.57 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $239.88 Typical High $257.04 | Professional | 54 · Surgery only | $213.80 | $239.88 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $47.86 Typical High $51.29 | Professional | 55 · Aftercare only | $42.66 | $47.86 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $31.62 Typical High $34.67 | Professional | 56 · Pre-op care only | $28.18 | $31.62 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $223.87 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $199.53 | $223.87 | $239.88 |
Where Georgia sits
The same service costs 6.8 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· 20th 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.