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 $112.20 Median $3,548.13 Typical High $7,585.78 | Facility | None | $112.20 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $114.82 Typical High $128.82 | Professional | None | $102.33 | $114.82 | $128.82 |
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 $97.72 Median $144.54 Typical High $251.19 | Professional | None | $97.72 | $144.54 | $251.19 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $186.21 Median $229.09 Typical High $398.11 | Professional | 50 · Both sides | $186.21 | $229.09 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $102.33 Typical High $295.12 | Facility | None | $75.86 | $102.33 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $169.82 Typical High $288.40 | Professional | None | $117.49 | $169.82 | $288.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $120.23 Median $151.36 Typical High $239.88 | Professional | None | $120.23 | $151.36 | $239.88 |
Oscar Health Setting Professional Modifier None Typical Low $165.96 Median $186.21 Typical High $213.80 | Professional | None | $165.96 | $186.21 | $213.80 |
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 $97.72 Median $158.49 Typical High $281.84 | Professional | None | $97.72 | $158.49 | $281.84 |
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 $51.29 Median $56.23 Typical High $61.66 | Professional | 52 · Reduced service | $51.29 | $56.23 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $22.39 Typical High $24.55 | Professional | 53 · Discontinued | $20.42 | $22.39 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $85.11 Typical High $91.20 | Professional | 54 · Surgery only | $75.86 | $85.11 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $16.98 Typical High $18.20 | Professional | 55 · Aftercare only | $15.14 | $16.98 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $11.22 Typical High $12.30 | Professional | 56 · Pre-op care only | $10.23 | $11.22 | $12.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $79.43 Typical High $85.11 | Professional | 78 · Unplanned return to OR | $70.79 | $79.43 | $85.11 |
Where Georgia sits
The same service costs 4.5 times more in Alaska than in Florida. 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
$145
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.