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 $245.47 Median $3,548.13 Typical High $7,585.78 | Facility | None | $245.47 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $295.12 Typical High $645.65 | Professional | None | $128.82 | $295.12 | $645.65 |
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 $104.71 Median $169.82 Typical High $288.40 | Professional | None | $104.71 | $169.82 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $158.49 Typical High $436.52 | Facility | None | $112.20 | $158.49 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $257.04 Typical High $616.60 | Professional | None | $128.82 | $257.04 | $616.60 |
Kaiser Permanente Setting Professional Modifier None Typical Low $123.03 Median $269.15 Typical High $346.74 | Professional | None | $123.03 | $269.15 | $346.74 |
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 $123.03 Median $257.04 Typical High $630.96 | Professional | None | $123.03 | $257.04 | $630.96 |
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 $123.03 Typical High $151.36 | Professional | 52 · Reduced service | $64.57 | $123.03 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $48.98 Typical High $60.26 | Professional | 53 · Discontinued | $26.30 | $48.98 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $181.97 Typical High $229.09 | Professional | 54 · Surgery only | $97.72 | $181.97 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $36.31 Typical High $45.71 | Professional | 55 · Aftercare only | $19.50 | $36.31 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $24.55 Typical High $30.20 | Professional | 56 · Pre-op care only | $12.88 | $24.55 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $169.82 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $91.20 | $169.82 | $213.80 |
Where Georgia sits
The same service costs 3.6 times more in Wisconsin than in Kentucky. 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· 41st of 51
$200
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.