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 $204.17 Median $3,630.78 Typical High $7,585.78 | Facility | None | $204.17 | $3,630.78 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $295.12 Typical High $501.19 | Professional | None | $199.53 | $295.12 | $501.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $478.63 Median $851.14 Typical High $3,630.78 | Facility | None | $478.63 | $851.14 | $3,630.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $194.98 Median $380.19 Typical High $660.69 | Professional | None | $194.98 | $380.19 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $389.05 Typical High $851.14 | Facility | None | $295.12 | $389.05 | $851.14 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $380.19 Typical High $602.56 | Professional | None | $239.88 | $380.19 | $602.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $213.80 Median $346.74 Typical High $524.81 | Professional | None | $213.80 | $346.74 | $524.81 |
United Setting Facility Modifier None Typical Low $79.43 Median $158.49 Typical High $1,778.28 | Facility | None | $79.43 | $158.49 | $1,778.28 |
United Setting Professional Modifier None Typical Low $223.87 Median $380.19 Typical High $741.31 | Professional | None | $223.87 | $380.19 | $741.31 |
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 $100.00 Median $147.91 Typical High $165.96 | Professional | 52 · Reduced service | $100.00 | $147.91 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $60.26 Typical High $66.07 | Professional | 53 · Discontinued | $39.81 | $60.26 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $223.87 Typical High $251.19 | Professional | 54 · Surgery only | $147.91 | $223.87 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $44.67 Typical High $50.12 | Professional | 55 · Aftercare only | $29.51 | $44.67 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $29.51 Typical High $33.11 | Professional | 56 · Pre-op care only | $19.95 | $29.51 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $208.93 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $138.04 | $208.93 | $234.42 |
Where Georgia sits
The same service costs 3.7 times more in Wisconsin 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· 19th of 51
$380
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.