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 $977.24 Median $5,370.32 Typical High $7,943.28 | Facility | None | $977.24 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $1,412.54 Typical High $1,698.24 | Professional | None | $436.52 | $1,412.54 | $1,698.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $1,148.15 Typical High $5,754.40 | Facility | None | $575.44 | $1,148.15 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $489.78 Median $1,230.27 Typical High $2,454.71 | Professional | None | $489.78 | $1,230.27 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $758.58 Median $2,041.74 Typical High $3,715.35 | Professional | 50 · Both sides | $758.58 | $2,041.74 | $3,715.35 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,949.84 Typical High $2,884.03 | Facility | None | $602.56 | $1,949.84 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $1,479.11 Typical High $3,388.44 | Professional | None | $446.68 | $1,479.11 | $3,388.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $457.09 Median $1,513.56 Typical High $2,754.23 | Professional | None | $457.09 | $1,513.56 | $2,754.23 |
Oscar Health Setting Professional Modifier None Typical Low $446.68 Median $1,230.27 Typical High $2,754.23 | Professional | None | $446.68 | $1,230.27 | $2,754.23 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $7,585.78 | Facility | None | $954.99 | $1,995.26 | $7,585.78 |
United Setting Professional Modifier None Typical Low $426.58 Median $1,380.38 Typical High $3,388.44 | Professional | None | $426.58 | $1,380.38 | $3,388.44 |
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 $660.69 Typical High $794.33 | Professional | 52 · Reduced service | $213.80 | $660.69 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $263.03 Typical High $316.23 | Professional | 53 · Discontinued | $85.11 | $263.03 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $977.24 Typical High $1,174.90 | Professional | 54 · Surgery only | $316.23 | $977.24 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $199.53 Typical High $234.42 | Professional | 55 · Aftercare only | $63.10 | $199.53 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $131.83 Typical High $158.49 | Professional | 56 · Pre-op care only | $42.66 | $131.83 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $912.01 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $295.12 | $912.01 | $1,096.48 |
Where Georgia sits
The same service costs 4.4 times more in Alaska than in Nebraska. 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· 33rd of 51
$1,349
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.