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 $275.42 Median $3,548.13 Typical High $7,413.10 | Facility | None | $275.42 | $3,548.13 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $275.42 Typical High $724.44 | Professional | None | $199.53 | $275.42 | $724.44 |
Ambetter Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $851.14 Typical High $4,570.88 | Facility | None | $389.05 | $851.14 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $199.53 Median $371.54 Typical High $660.69 | Professional | None | $199.53 | $371.54 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $758.58 Typical High $1,023.29 | Facility | None | $398.11 | $758.58 | $1,023.29 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $371.54 Typical High $588.84 | Professional | None | $257.04 | $371.54 | $588.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $213.80 Median $323.59 Typical High $426.58 | Professional | None | $213.80 | $323.59 | $426.58 |
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 $229.09 Median $380.19 Typical High $691.83 | Professional | None | $229.09 | $380.19 | $691.83 |
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 $138.04 Typical High $154.88 | Professional | 52 · Reduced service | $100.00 | $138.04 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $54.95 Typical High $61.66 | Professional | 53 · Discontinued | $39.81 | $54.95 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $208.93 Typical High $234.42 | Professional | 54 · Surgery only | $151.36 | $208.93 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $41.69 Typical High $46.77 | Professional | 55 · Aftercare only | $30.20 | $41.69 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $27.54 Typical High $30.90 | Professional | 56 · Pre-op care only | $19.95 | $27.54 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $194.98 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $141.25 | $194.98 | $218.78 |
Where Georgia sits
The same service costs 4.3 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· 21st of 51
$389
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.