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 $524.81 Median $5,370.32 Typical High $7,943.28 | Facility | None | $524.81 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $549.54 Typical High $1,445.44 | Professional | None | $371.54 | $549.54 | $1,445.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $660.69 Median $1,202.26 Typical High $4,570.88 | Facility | None | $660.69 | $1,202.26 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $331.13 Median $512.86 Typical High $891.25 | Professional | None | $331.13 | $512.86 | $891.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $588.84 Median $812.83 Typical High $1,380.38 | Professional | 50 · Both sides | $588.84 | $812.83 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $891.25 Typical High $1,258.93 | Facility | None | $676.08 | $891.25 | $1,258.93 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $676.08 Typical High $1,174.90 | Professional | None | $426.58 | $676.08 | $1,174.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $398.11 Median $602.56 Typical High $912.01 | Professional | None | $398.11 | $602.56 | $912.01 |
Oscar Health Setting Professional Modifier None Typical Low $562.34 Median $794.33 Typical High $891.25 | Professional | None | $562.34 | $794.33 | $891.25 |
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 $380.19 Median $660.69 Typical High $1,174.90 | Professional | None | $380.19 | $660.69 | $1,174.90 |
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 $186.21 Median $239.88 Typical High $288.40 | Professional | 52 · Reduced service | $186.21 | $239.88 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $95.50 Typical High $114.82 | Professional | 53 · Discontinued | $75.86 | $95.50 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $354.81 Typical High $426.58 | Professional | 54 · Surgery only | $281.84 | $354.81 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $70.79 Typical High $87.10 | Professional | 55 · Aftercare only | $56.23 | $70.79 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $47.86 Typical High $57.54 | Professional | 56 · Pre-op care only | $37.15 | $47.86 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $331.13 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $263.03 | $331.13 | $398.11 |
Where Georgia sits
The same service costs 4.8 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· 25th of 51
$589
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.