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 $1,202.26 Median $5,370.32 Typical High $7,762.47 | Facility | None | $1,202.26 | $5,370.32 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $1,621.81 Typical High $2,238.72 | Professional | None | $380.19 | $1,621.81 | $2,238.72 |
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 $426.58 Median $1,412.54 Typical High $2,884.03 | Professional | None | $426.58 | $1,412.54 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $660.69 Median $2,089.30 Typical High $4,365.16 | Professional | 50 · Both sides | $660.69 | $2,089.30 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,949.84 Typical High $2,691.53 | Facility | None | $602.56 | $1,949.84 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $1,479.11 Typical High $3,715.35 | Professional | None | $380.19 | $1,479.11 | $3,715.35 |
Kaiser Permanente Setting Professional Modifier None Typical Low $398.11 Median $1,778.28 Typical High $3,235.94 | Professional | None | $398.11 | $1,778.28 | $3,235.94 |
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 $363.08 Median $1,380.38 Typical High $3,981.07 | Professional | None | $363.08 | $1,380.38 | $3,981.07 |
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 $181.97 Median $758.58 Typical High $912.01 | Professional | 52 · Reduced service | $181.97 | $758.58 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $302.00 Typical High $363.08 | Professional | 53 · Discontinued | $74.13 | $302.00 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $1,148.15 Typical High $1,380.38 | Professional | 54 · Surgery only | $275.42 | $1,148.15 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $229.09 Typical High $275.42 | Professional | 55 · Aftercare only | $54.95 | $229.09 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $151.36 Typical High $181.97 | Professional | 56 · Pre-op care only | $37.15 | $151.36 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $1,071.52 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $257.04 | $1,071.52 | $1,288.25 |
Where Georgia sits
The same service costs 5.8 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· 23rd of 51
$1,549
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.