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 $316.23 Median $3,630.78 Typical High $7,585.78 | Facility | None | $316.23 | $3,630.78 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $489.78 Typical High $954.99 | Professional | None | $316.23 | $489.78 | $954.99 |
Ambetter Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | None | $537.03 | $537.03 | $537.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $512.86 Median $1,000.00 Typical High $4,570.88 | Facility | None | $512.86 | $1,000.00 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $281.84 Median $436.52 Typical High $776.25 | Professional | None | $281.84 | $436.52 | $776.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $512.86 Median $707.95 Typical High $1,202.26 | Professional | 50 · Both sides | $512.86 | $707.95 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $891.25 Typical High $1,148.15 | Facility | None | $524.81 | $891.25 | $1,148.15 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $588.84 Typical High $1,023.29 | Professional | None | $354.81 | $588.84 | $1,023.29 |
Kaiser Permanente Setting Professional Modifier None Typical Low $346.74 Median $524.81 Typical High $741.31 | Professional | None | $346.74 | $524.81 | $741.31 |
Oscar Health Setting Professional Modifier None Typical Low $478.63 Median $691.83 Typical High $776.25 | Professional | None | $478.63 | $691.83 | $776.25 |
United Setting Facility Modifier None Typical Low $501.19 Median $724.44 Typical High $3,548.13 | Facility | None | $501.19 | $724.44 | $3,548.13 |
United Setting Professional Modifier None Typical Low $323.59 Median $575.44 Typical High $1,047.13 | Professional | None | $323.59 | $575.44 | $1,047.13 |
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 $158.49 Median $208.93 Typical High $251.19 | Professional | 52 · Reduced service | $158.49 | $208.93 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $83.18 Typical High $100.00 | Professional | 53 · Discontinued | $63.10 | $83.18 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $316.23 Typical High $380.19 | Professional | 54 · Surgery only | $239.88 | $316.23 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $63.10 Typical High $75.86 | Professional | 55 · Aftercare only | $47.86 | $63.10 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $41.69 Typical High $50.12 | Professional | 56 · Pre-op care only | $31.62 | $41.69 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $295.12 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $223.87 | $295.12 | $354.81 |
Where Georgia sits
The same service costs 4.9 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· 24th of 51
$513
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.