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 $588.84 Median $4,466.84 Typical High $7,585.78 | Facility | None | $588.84 | $4,466.84 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $524.81 Typical High $645.65 | Professional | None | $363.08 | $524.81 | $645.65 |
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 $302.00 Median $501.19 Typical High $851.14 | Professional | None | $302.00 | $501.19 | $851.14 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $549.54 Median $758.58 Typical High $1,258.93 | Professional | 50 · Both sides | $549.54 | $758.58 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,348.96 Typical High $1,778.28 | Facility | None | $524.81 | $1,348.96 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $660.69 Typical High $1,318.26 | Professional | None | $389.05 | $660.69 | $1,318.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $416.87 Median $645.65 Typical High $1,047.13 | Professional | None | $416.87 | $645.65 | $1,047.13 |
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 $346.74 Median $630.96 Typical High $1,412.54 | Professional | None | $346.74 | $630.96 | $1,412.54 |
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 $181.97 Median $251.19 Typical High $316.23 | Professional | 52 · Reduced service | $181.97 | $251.19 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $100.00 Typical High $128.82 | Professional | 53 · Discontinued | $72.44 | $100.00 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $371.54 Typical High $478.63 | Professional | 54 · Surgery only | $269.15 | $371.54 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $74.13 Typical High $95.50 | Professional | 55 · Aftercare only | $53.70 | $74.13 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $50.12 Typical High $63.10 | Professional | 56 · Pre-op care only | $36.31 | $50.12 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $346.74 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $251.19 | $346.74 | $446.68 |
Where Georgia sits
The same service costs 4.7 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· 29th of 51
$562
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.