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 $524.81 Median $4,466.84 Typical High $7,585.78 | Facility | None | $524.81 | $4,466.84 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $524.81 Typical High $741.31 | Professional | None | $363.08 | $524.81 | $741.31 |
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 $436.52 Median $691.83 Typical High $1,148.15 | Professional | None | $436.52 | $691.83 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,698.24 Typical High $2,187.76 | Facility | None | $524.81 | $1,698.24 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $741.31 Typical High $1,202.26 | Professional | None | $398.11 | $741.31 | $1,202.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $389.05 Median $616.60 Typical High $1,288.25 | Professional | None | $389.05 | $616.60 | $1,288.25 |
United Setting Facility Modifier None Typical Low $501.19 Median $724.44 Typical High $3,548.13 | Facility | None | $501.19 | $724.44 | $3,548.13 |
United Setting Professional Modifier None Typical Low $371.54 Median $707.95 Typical High $1,380.38 | Professional | None | $371.54 | $707.95 | $1,380.38 |
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 $263.03 Typical High $302.00 | Professional | 52 · Reduced service | $181.97 | $263.03 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $104.71 Typical High $120.23 | Professional | 53 · Discontinued | $72.44 | $104.71 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $389.05 Typical High $446.68 | Professional | 54 · Surgery only | $269.15 | $389.05 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $77.62 Typical High $91.20 | Professional | 55 · Aftercare only | $54.95 | $77.62 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $52.48 Typical High $60.26 | Professional | 56 · Pre-op care only | $36.31 | $52.48 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $363.08 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $251.19 | $363.08 | $416.87 |
Where Georgia sits
The same service costs 4.4 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· 15th of 51
$724
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.