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 $257.04 Median $3,548.13 Typical High $7,585.78 | Facility | None | $257.04 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $263.03 Typical High $346.74 | Professional | None | $234.42 | $263.03 | $346.74 |
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 $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 $213.80 Median $323.59 Typical High $562.34 | Professional | None | $213.80 | $323.59 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $165.96 Typical High $457.09 | Facility | None | $117.49 | $165.96 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $389.05 Typical High $630.96 | Professional | None | $257.04 | $389.05 | $630.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $263.03 Median $338.84 Typical High $489.78 | Professional | None | $263.03 | $338.84 | $489.78 |
Oscar Health Setting Professional Modifier None Typical Low $363.08 Median $407.38 Typical High $478.63 | Professional | None | $363.08 | $407.38 | $478.63 |
United Setting Facility Modifier None Typical Low $79.43 Median $158.49 Typical High $1,778.28 | Facility | None | $79.43 | $158.49 | $1,778.28 |
United Setting Professional Modifier None Typical Low $223.87 Median $371.54 Typical High $630.96 | Professional | None | $223.87 | $371.54 | $630.96 |
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 $114.82 Median $128.82 Typical High $138.04 | Professional | 52 · Reduced service | $114.82 | $128.82 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $51.29 Typical High $56.23 | Professional | 53 · Discontinued | $45.71 | $51.29 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $194.98 Typical High $208.93 | Professional | 54 · Surgery only | $173.78 | $194.98 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $38.90 Typical High $41.69 | Professional | 55 · Aftercare only | $34.67 | $38.90 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $25.70 Typical High $28.18 | Professional | 56 · Pre-op care only | $22.91 | $25.70 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $181.97 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $162.18 | $181.97 | $194.98 |
Where Georgia sits
The same service costs 5.1 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
$324
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.