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 $165.96 Median $5,370.32 Typical High $7,585.78 | Facility | None | $165.96 | $5,370.32 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $245.47 Typical High $316.23 | Professional | None | $165.96 | $245.47 | $316.23 |
Ambetter Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $380.19 Median $776.25 Typical High $3,630.78 | Facility | None | $380.19 | $776.25 | $3,630.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $144.54 Median $295.12 Typical High $549.54 | Professional | None | $144.54 | $295.12 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $158.49 Typical High $436.52 | Facility | None | $112.20 | $158.49 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $295.12 Typical High $512.86 | Professional | None | $181.97 | $295.12 | $512.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $154.88 Median $257.04 Typical High $323.59 | Professional | None | $154.88 | $257.04 | $323.59 |
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 $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 $83.18 Median $123.03 Typical High $151.36 | Professional | 52 · Reduced service | $83.18 | $123.03 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $48.98 Typical High $60.26 | Professional | 53 · Discontinued | $33.11 | $48.98 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $186.21 Typical High $223.87 | Professional | 54 · Surgery only | $123.03 | $186.21 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $37.15 Typical High $44.67 | Professional | 55 · Aftercare only | $24.55 | $37.15 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $24.55 Typical High $30.20 | Professional | 56 · Pre-op care only | $16.60 | $24.55 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $173.78 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $114.82 | $173.78 | $208.93 |
Where Georgia sits
The same service costs 3.7 times more in Wisconsin 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· 16th of 51
$295
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.