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 $234.42 Median $3,548.13 Typical High $7,585.78 | Facility | None | $234.42 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $229.09 Typical High $263.03 | Professional | None | $199.53 | $229.09 | $263.03 |
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 $162.18 Median $269.15 Typical High $436.52 | Professional | None | $162.18 | $269.15 | $436.52 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $302.00 Median $426.58 Typical High $691.83 | Professional | 50 · Both sides | $302.00 | $426.58 | $691.83 |
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 $213.80 Median $302.00 Typical High $575.44 | Professional | None | $213.80 | $302.00 | $575.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $239.88 Median $316.23 Typical High $478.63 | Professional | None | $239.88 | $316.23 | $478.63 |
Oscar Health Setting Professional Modifier None Typical Low $316.23 Median $380.19 Typical High $436.52 | Professional | None | $316.23 | $380.19 | $436.52 |
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 $165.96 Median $281.84 Typical High $616.60 | Professional | None | $165.96 | $281.84 | $616.60 |
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 $97.72 Median $112.20 Typical High $125.89 | Professional | 52 · Reduced service | $97.72 | $112.20 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $45.71 Typical High $50.12 | Professional | 53 · Discontinued | $38.90 | $45.71 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $169.82 Typical High $186.21 | Professional | 54 · Surgery only | $147.91 | $169.82 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $33.88 Typical High $37.15 | Professional | 55 · Aftercare only | $29.51 | $33.88 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $22.91 Typical High $25.12 | Professional | 56 · Pre-op care only | $19.50 | $22.91 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $158.49 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $138.04 | $158.49 | $173.78 |
Where Georgia sits
The same service costs 5.0 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· 21st of 51
$269
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.