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 $177.83 Median $3,548.13 Typical High $7,585.78 | Facility | None | $177.83 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $204.17 Typical High $489.78 | Professional | None | $117.49 | $204.17 | $489.78 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | 50 · Both sides | $147.91 | $147.91 | $147.91 |
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 $83.18 Median $154.88 Typical High $257.04 | Professional | None | $83.18 | $154.88 | $257.04 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $165.96 Median $229.09 Typical High $380.19 | Professional | 50 · Both sides | $165.96 | $229.09 | $380.19 |
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 $114.82 Median $199.53 Typical High $446.68 | Professional | None | $114.82 | $199.53 | $446.68 |
Kaiser Permanente Setting Professional Modifier None Typical Low $114.82 Median $204.17 Typical High $251.19 | Professional | None | $114.82 | $204.17 | $251.19 |
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 $109.65 Median $204.17 Typical High $457.09 | Professional | None | $109.65 | $204.17 | $457.09 |
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 $58.88 Median $89.13 Typical High $104.71 | Professional | 52 · Reduced service | $58.88 | $89.13 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $35.48 Typical High $41.69 | Professional | 53 · Discontinued | $23.44 | $35.48 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $134.90 Typical High $158.49 | Professional | 54 · Surgery only | $87.10 | $134.90 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $26.92 Typical High $31.62 | Professional | 55 · Aftercare only | $17.38 | $26.92 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $17.78 Typical High $20.89 | Professional | 56 · Pre-op care only | $11.75 | $17.78 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $125.89 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $81.28 | $125.89 | $147.91 |
Where Georgia sits
The same service costs 4.5 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· 39th of 51
$174
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.