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 $524.81 Median $4,466.84 Typical High $7,585.78 | Facility | None | $524.81 | $4,466.84 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $524.81 Typical High $794.33 | Professional | None | $426.58 | $524.81 | $794.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $512.86 Median $1,000.00 Typical High $4,570.88 | Facility | None | $512.86 | $1,000.00 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $275.42 Median $478.63 Typical High $758.58 | Professional | None | $275.42 | $478.63 | $758.58 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $512.86 Median $724.44 Typical High $1,174.90 | Professional | 50 · Both sides | $512.86 | $724.44 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,698.24 Typical High $2,187.76 | Facility | None | $524.81 | $1,698.24 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $575.44 Typical High $1,023.29 | Professional | None | $398.11 | $575.44 | $1,023.29 |
Kaiser Permanente Setting Professional Modifier None Typical Low $363.08 Median $478.63 Typical High $660.69 | Professional | None | $363.08 | $478.63 | $660.69 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,479.11 Typical High $5,011.87 | Facility | None | $851.14 | $1,479.11 | $5,011.87 |
United Setting Professional Modifier None Typical Low $380.19 Median $602.56 Typical High $1,047.13 | Professional | None | $380.19 | $602.56 | $1,047.13 |
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 $213.80 Median $251.19 Typical High $281.84 | Professional | 52 · Reduced service | $213.80 | $251.19 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $100.00 Typical High $112.20 | Professional | 53 · Discontinued | $85.11 | $100.00 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $380.19 Typical High $416.87 | Professional | 54 · Surgery only | $323.59 | $380.19 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $75.86 Typical High $83.18 | Professional | 55 · Aftercare only | $64.57 | $75.86 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $50.12 Typical High $56.23 | Professional | 56 · Pre-op care only | $42.66 | $50.12 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $354.81 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $302.00 | $354.81 | $389.05 |
Where Georgia sits
The same service costs 4.9 times more in Alaska than in Utah. 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· 35th of 51
$537
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.