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 $1,584.89 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,584.89 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,584.89 Typical High $1,949.84 | Professional | None | $1,513.56 | $1,584.89 | $1,949.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,096.48 Typical High $5,495.41 | Facility | None | $524.81 | $1,096.48 | $5,495.41 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,412.54 Median $1,995.26 Typical High $3,162.28 | Professional | None | $1,412.54 | $1,995.26 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $549.54 Typical High $2,691.53 | Facility | None | $457.09 | $549.54 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $2,290.87 Typical High $3,981.07 | Professional | None | $1,445.44 | $2,290.87 | $3,981.07 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,513.56 Median $1,698.24 Typical High $2,290.87 | Professional | None | $1,513.56 | $1,698.24 | $2,290.87 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,479.11 Typical High $5,128.61 | Facility | None | $851.14 | $1,479.11 | $5,128.61 |
United Setting Professional Modifier None Typical Low $1,412.54 Median $2,089.30 Typical High $4,786.30 | Professional | None | $1,412.54 | $2,089.30 | $4,786.30 |
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 $758.58 Median $794.33 Typical High $870.96 | Professional | 52 · Reduced service | $758.58 | $794.33 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $316.23 Typical High $346.74 | Professional | 53 · Discontinued | $302.00 | $316.23 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,202.26 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,122.02 | $1,202.26 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $239.88 Typical High $257.04 | Professional | 55 · Aftercare only | $223.87 | $239.88 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $158.49 Typical High $173.78 | Professional | 56 · Pre-op care only | $151.36 | $158.49 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,122.02 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,122.02 | $1,202.26 |
Where Georgia sits
The same service costs 5.2 times more in Alaska than in Texas. 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· 27th of 51
$1,950
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.