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 $154.88 Median $3,548.13 Typical High $7,585.78 | Facility | None | $154.88 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $154.88 Typical High $213.80 | Professional | None | $128.82 | $154.88 | $213.80 |
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 $114.82 Median $177.83 Typical High $302.00 | Professional | None | $114.82 | $177.83 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $204.17 Typical High $602.56 | Facility | None | $154.88 | $204.17 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $223.87 Typical High $346.74 | Professional | None | $147.91 | $223.87 | $346.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $141.25 Median $190.55 Typical High $275.42 | Professional | None | $141.25 | $190.55 | $275.42 |
Oscar Health Setting Professional Modifier None Typical Low $194.98 Median $234.42 Typical High $269.15 | Professional | None | $194.98 | $234.42 | $269.15 |
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 $128.82 Median $208.93 Typical High $354.81 | Professional | None | $128.82 | $208.93 | $354.81 |
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 $64.57 Median $74.13 Typical High $81.28 | Professional | 52 · Reduced service | $64.57 | $74.13 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $29.51 Typical High $32.36 | Professional | 53 · Discontinued | $25.70 | $29.51 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $109.65 Typical High $123.03 | Professional | 54 · Surgery only | $97.72 | $109.65 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $21.88 Typical High $24.55 | Professional | 55 · Aftercare only | $19.50 | $21.88 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $14.79 Typical High $16.22 | Professional | 56 · Pre-op care only | $12.88 | $14.79 | $16.22 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $102.33 Typical High $114.82 | Professional | 78 · Unplanned return to OR | $91.20 | $102.33 | $114.82 |
Where Georgia sits
The same service costs 3.8 times more in Alaska than in Delaware. 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· 24th of 51
$186
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.