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 $537.03 Median $5,011.87 Typical High $7,943.28 | Facility | None | $537.03 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $616.60 | Professional | None | $467.74 | $467.74 | $616.60 |
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 $338.84 Median $676.08 Typical High $1,096.48 | Professional | None | $338.84 | $676.08 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,445.44 Typical High $1,905.46 | Facility | None | $524.81 | $1,445.44 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $758.58 Typical High $1,412.54 | Professional | None | $501.19 | $758.58 | $1,412.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $512.86 Median $602.56 Typical High $851.14 | Professional | None | $512.86 | $602.56 | $851.14 |
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 $467.74 Median $691.83 Typical High $1,202.26 | Professional | None | $467.74 | $691.83 | $1,202.26 |
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 $234.42 Median $234.42 Typical High $269.15 | Professional | 52 · Reduced service | $234.42 | $234.42 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $109.65 | Professional | 53 · Discontinued | $93.33 | $93.33 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $354.81 Typical High $407.38 | Professional | 54 · Surgery only | $354.81 | $354.81 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $70.79 Typical High $81.28 | Professional | 55 · Aftercare only | $70.79 | $70.79 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $53.70 | Professional | 56 · Pre-op care only | $46.77 | $46.77 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $331.13 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $331.13 | $331.13 | $380.19 |
Where Georgia sits
The same service costs 5.5 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· 29th of 51
$692
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.