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 $134.90 Median $4,168.69 Typical High $7,585.78 | Facility | None | $134.90 | $4,168.69 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $263.03 Typical High $512.86 | Professional | None | $134.90 | $263.03 | $512.86 |
Ambetter Setting Professional Modifier None Typical Low $131.83 Median $426.58 Typical High $467.74 | Professional | None | $131.83 | $426.58 | $467.74 |
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 $123.03 Median $186.21 Typical High $346.74 | Professional | None | $123.03 | $186.21 | $346.74 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $218.78 Median $302.00 Typical High $562.34 | Professional | 50 · Both sides | $218.78 | $302.00 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $223.87 Typical High $602.56 | Facility | None | $165.96 | $223.87 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $288.40 Typical High $537.03 | Professional | None | $151.36 | $288.40 | $537.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $147.91 Median $281.84 Typical High $398.11 | Professional | None | $147.91 | $281.84 | $398.11 |
Oscar Health Setting Professional Modifier None Typical Low $204.17 Median $363.08 Typical High $407.38 | Professional | None | $204.17 | $363.08 | $407.38 |
United Setting Facility Modifier None Typical Low $331.13 Median $501.19 Typical High $2,454.71 | Facility | None | $331.13 | $501.19 | $2,454.71 |
United Setting Professional Modifier None Typical Low $138.04 Median $269.15 Typical High $549.54 | Professional | None | $138.04 | $269.15 | $549.54 |
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 $67.61 Median $109.65 Typical High $134.90 | Professional | 52 · Reduced service | $67.61 | $109.65 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $43.65 Typical High $53.70 | Professional | 53 · Discontinued | $26.92 | $43.65 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $165.96 Typical High $204.17 | Professional | 54 · Surgery only | $102.33 | $165.96 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $33.11 Typical High $40.74 | Professional | 55 · Aftercare only | $20.42 | $33.11 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $21.88 Typical High $26.92 | Professional | 56 · Pre-op care only | $13.49 | $21.88 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $154.88 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $95.50 | $154.88 | $190.55 |
Where Georgia sits
The same service costs 3.6 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· 33rd of 51
$229
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.