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 $389.05 Median $4,466.84 Typical High $7,585.78 | Facility | None | $389.05 | $4,466.84 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $371.54 Typical High $416.87 | Professional | None | $239.88 | $371.54 | $416.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $512.86 Median $1,071.52 Typical High $5,754.40 | Facility | None | $512.86 | $1,071.52 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $239.88 Median $323.59 Typical High $602.56 | Professional | None | $239.88 | $323.59 | $602.56 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $371.54 Median $524.81 Typical High $954.99 | Professional | 50 · Both sides | $371.54 | $524.81 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,905.46 Typical High $2,344.23 | Facility | None | $524.81 | $1,905.46 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $467.74 Typical High $812.83 | Professional | None | $269.15 | $467.74 | $812.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $263.03 Median $416.87 Typical High $602.56 | Professional | None | $263.03 | $416.87 | $602.56 |
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 $245.47 Median $436.52 Typical High $812.83 | Professional | None | $245.47 | $436.52 | $812.83 |
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 $120.23 Median $165.96 Typical High $199.53 | Professional | 52 · Reduced service | $120.23 | $165.96 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $66.07 Typical High $79.43 | Professional | 53 · Discontinued | $47.86 | $66.07 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $251.19 Typical High $302.00 | Professional | 54 · Surgery only | $177.83 | $251.19 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $50.12 Typical High $60.26 | Professional | 55 · Aftercare only | $35.48 | $50.12 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $33.11 Typical High $39.81 | Professional | 56 · Pre-op care only | $23.99 | $33.11 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $234.42 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $165.96 | $234.42 | $281.84 |
Where Georgia sits
The same service costs 5.5 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· 27th of 51
$398
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.