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 $562.34 Median $5,370.32 Typical High $7,943.28 | Facility | None | $562.34 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $588.84 Typical High $1,412.54 | Professional | None | $371.54 | $588.84 | $1,412.54 |
Ambetter Setting Professional Modifier None Typical Low $239.88 Median $501.19 Typical High $912.01 | Professional | None | $239.88 | $501.19 | $912.01 |
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 $436.52 Median $724.44 Typical High $1,318.26 | Professional | None | $436.52 | $724.44 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $645.65 Median $1,148.15 Typical High $1,995.26 | Professional | 50 · Both sides | $645.65 | $1,148.15 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $275.42 Median $489.78 Typical High $831.76 | Professional | 62 · Two surgeons | $275.42 | $489.78 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $338.84 Typical High $1,000.00 | Facility | None | $251.19 | $338.84 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $912.01 Typical High $1,513.56 | Professional | None | $630.96 | $912.01 | $1,513.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $371.54 Median $588.84 Typical High $1,737.80 | Professional | None | $371.54 | $588.84 | $1,737.80 |
Oscar Health Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | None | $933.25 | $933.25 | $933.25 |
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 $457.09 Median $831.76 Typical High $1,548.82 | Professional | None | $457.09 | $831.76 | $1,548.82 |
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 $257.04 Typical High $309.03 | Professional | 52 · Reduced service | $181.97 | $257.04 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $102.33 Typical High $123.03 | Professional | 53 · Discontinued | $74.13 | $102.33 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $389.05 Typical High $467.74 | Professional | 54 · Surgery only | $275.42 | $389.05 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $77.62 Typical High $93.33 | Professional | 55 · Aftercare only | $54.95 | $77.62 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $51.29 Typical High $61.66 | Professional | 56 · Pre-op care only | $37.15 | $51.29 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $363.08 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $257.04 | $363.08 | $436.52 |
Where Georgia sits
The same service costs 4.3 times more in Wisconsin 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· 20th of 51
$794
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.