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 $109.65 Median $5,370.32 Typical High $7,585.78 | Facility | None | $109.65 | $5,370.32 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $144.54 Typical High $177.83 | Professional | None | $109.65 | $144.54 | $177.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $831.76 Typical High $4,570.88 | Facility | None | $389.05 | $831.76 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $75.86 Median $144.54 Typical High $229.09 | Professional | None | $75.86 | $144.54 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $151.36 Typical High $602.56 | Facility | None | $114.82 | $151.36 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $177.83 Typical High $371.54 | Professional | None | $107.15 | $177.83 | $371.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $107.15 Median $173.78 Typical High $204.17 | Professional | None | $107.15 | $173.78 | $204.17 |
United Setting Facility Modifier None Typical Low $501.19 Median $724.44 Typical High $3,548.13 | Facility | None | $501.19 | $724.44 | $3,548.13 |
United Setting Professional Modifier None Typical Low $102.33 Median $181.97 Typical High $371.54 | Professional | None | $102.33 | $181.97 | $371.54 |
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 $54.95 Median $72.44 Typical High $87.10 | Professional | 52 · Reduced service | $54.95 | $72.44 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $28.84 Typical High $34.67 | Professional | 53 · Discontinued | $21.88 | $28.84 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $107.15 Typical High $128.82 | Professional | 54 · Surgery only | $83.18 | $107.15 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $21.38 Typical High $25.70 | Professional | 55 · Aftercare only | $16.60 | $21.38 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $14.45 Typical High $17.38 | Professional | 56 · Pre-op care only | $10.96 | $14.45 | $17.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $100.00 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $77.62 | $100.00 | $120.23 |
Where Georgia sits
The same service costs 4.4 times more in Alaska 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· 32nd of 51
$162
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.