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 $229.09 Median $3,548.13 Typical High $7,585.78 | Facility | None | $229.09 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $269.15 Typical High $707.95 | Professional | None | $169.82 | $269.15 | $707.95 |
Ambetter Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | None | $275.42 | $275.42 | $275.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $831.76 Typical High $4,570.88 | Facility | None | $389.05 | $831.76 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $181.97 Median $338.84 Typical High $549.54 | Professional | None | $181.97 | $338.84 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $269.15 Typical High $645.65 | Facility | None | $204.17 | $269.15 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $302.00 Typical High $537.03 | Professional | None | $186.21 | $302.00 | $537.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $169.82 Median $281.84 Typical High $363.08 | Professional | None | $169.82 | $281.84 | $363.08 |
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 $173.78 Median $309.03 Typical High $616.60 | Professional | None | $173.78 | $309.03 | $616.60 |
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 $85.11 Median $114.82 Typical High $147.91 | Professional | 52 · Reduced service | $85.11 | $114.82 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $45.71 Typical High $58.88 | Professional | 53 · Discontinued | $33.88 | $45.71 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $169.82 Typical High $223.87 | Professional | 54 · Surgery only | $128.82 | $169.82 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $33.88 Typical High $44.67 | Professional | 55 · Aftercare only | $25.70 | $33.88 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $22.91 Typical High $29.51 | Professional | 56 · Pre-op care only | $16.98 | $22.91 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $158.49 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $120.23 | $158.49 | $208.93 |
Where Georgia sits
The same service costs 4.3 times more in Wisconsin than in Kentucky. 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· 16th of 51
$339
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.