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 $4,897.79 Typical High $7,943.28 | Facility | None | $389.05 | $4,897.79 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $407.38 Typical High $794.33 | Professional | None | $257.04 | $407.38 | $794.33 |
Ambetter Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $512.86 | Professional | None | $457.09 | $457.09 | $512.86 |
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 $229.09 Median $346.74 Typical High $630.96 | Professional | None | $229.09 | $346.74 | $630.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $416.87 Median $549.54 Typical High $977.24 | Professional | 50 · Both sides | $416.87 | $549.54 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $239.88 Median $316.23 Typical High $1,513.56 | Facility | None | $239.88 | $316.23 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $501.19 Typical High $851.14 | Professional | None | $288.40 | $501.19 | $851.14 |
Kaiser Permanente Setting Professional Modifier None Typical Low $281.84 Median $436.52 Typical High $630.96 | Professional | None | $281.84 | $436.52 | $630.96 |
Oscar Health Setting Professional Modifier None Typical Low $389.05 Median $575.44 Typical High $660.69 | Professional | None | $389.05 | $575.44 | $660.69 |
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 $263.03 Median $467.74 Typical High $870.96 | Professional | None | $263.03 | $467.74 | $870.96 |
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 $128.82 Median $173.78 Typical High $208.93 | Professional | 52 · Reduced service | $128.82 | $173.78 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $69.18 Typical High $83.18 | Professional | 53 · Discontinued | $51.29 | $69.18 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $263.03 Typical High $316.23 | Professional | 54 · Surgery only | $190.55 | $263.03 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $52.48 Typical High $63.10 | Professional | 55 · Aftercare only | $38.02 | $52.48 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $34.67 Typical High $41.69 | Professional | 56 · Pre-op care only | $25.70 | $34.67 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $245.47 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $177.83 | $245.47 | $295.12 |
Where Georgia sits
The same service costs 4.3 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· 25th of 51
$417
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.