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 $758.58 Median $5,370.32 Typical High $7,943.28 | Facility | None | $758.58 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $758.58 | Professional | None | $501.19 | $501.19 | $758.58 |
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 $467.74 Median $707.95 Typical High $1,148.15 | Professional | None | $467.74 | $707.95 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,862.09 Typical High $2,454.71 | Facility | None | $602.56 | $1,862.09 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $794.33 Typical High $1,479.11 | Professional | None | $588.84 | $794.33 | $1,479.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $537.03 Median $645.65 Typical High $977.24 | Professional | None | $537.03 | $645.65 | $977.24 |
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 $489.78 Median $707.95 Typical High $1,258.93 | Professional | None | $489.78 | $707.95 | $1,258.93 |
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 $251.19 Median $251.19 Typical High $295.12 | Professional | 52 · Reduced service | $251.19 | $251.19 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $100.00 Typical High $120.23 | Professional | 53 · Discontinued | $100.00 | $100.00 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $371.54 Typical High $446.68 | Professional | 54 · Surgery only | $371.54 | $371.54 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $74.13 Typical High $89.13 | Professional | 55 · Aftercare only | $74.13 | $74.13 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $50.12 Typical High $58.88 | Professional | 56 · Pre-op care only | $50.12 | $50.12 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $346.74 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $346.74 | $346.74 | $416.87 |
Where Georgia sits
The same service costs 5.4 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· 27th of 51
$741
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.