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 $1,318.26 Median $6,165.95 Typical High $13,803.84 | Facility | None | $1,318.26 | $6,165.95 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,318.26 Typical High $1,621.81 | Professional | None | $1,288.25 | $1,318.26 | $1,621.81 |
Ambetter Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Professional | None | $2,630.27 | $2,630.27 | $2,630.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,071.52 Median $2,137.96 Typical High $12,882.50 | Facility | None | $1,071.52 | $2,137.96 | $12,882.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $1,778.28 Typical High $2,884.03 | Professional | None | $1,148.15 | $1,778.28 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,949.84 Median $2,754.23 Typical High $4,570.88 | Professional | 50 · Both sides | $1,949.84 | $2,754.23 | $4,570.88 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $10,000.00 Typical High $13,182.57 | Facility | None | $602.56 | $10,000.00 | $13,182.57 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $2,041.74 Typical High $3,388.44 | Professional | None | $1,479.11 | $2,041.74 | $3,388.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,348.96 Median $1,513.56 Typical High $2,137.96 | Professional | None | $1,348.96 | $1,513.56 | $2,137.96 |
Oscar Health Setting Professional Modifier None Typical Low $1,318.26 Median $2,238.72 Typical High $2,691.53 | Professional | None | $1,318.26 | $2,238.72 | $2,691.53 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $3,715.35 Typical High $10,000.00 | Facility | None | $1,513.56 | $3,715.35 | $10,000.00 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $1,905.46 Typical High $3,235.94 | Professional | None | $1,148.15 | $1,905.46 | $3,235.94 |
4 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 54 · Surgery only Typical Low $977.24 Median $977.24 Typical High $1,096.48 | Professional | 54 · Surgery only | $977.24 | $977.24 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $199.53 Typical High $218.78 | Professional | 55 · Aftercare only | $194.98 | $199.53 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $147.91 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $1,023.29 |
Where Georgia sits
The same service costs 8.1 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· 23rd of 51
$1,862
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.