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 $363.08 Median $3,548.13 Typical High $7,585.78 | Facility | None | $363.08 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $363.08 Typical High $407.38 | Professional | None | $229.09 | $363.08 | $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 $239.88 Median $407.38 Typical High $691.83 | Professional | None | $239.88 | $407.38 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $380.19 Typical High $660.69 | Facility | None | $295.12 | $380.19 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $380.19 Typical High $630.96 | Professional | None | $251.19 | $380.19 | $630.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $229.09 Median $363.08 Typical High $467.74 | Professional | None | $229.09 | $363.08 | $467.74 |
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 $239.88 Median $416.87 Typical High $794.33 | Professional | None | $239.88 | $416.87 | $794.33 |
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 $114.82 Median $165.96 Typical High $190.55 | Professional | 52 · Reduced service | $114.82 | $165.96 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $67.61 Typical High $75.86 | Professional | 53 · Discontinued | $45.71 | $67.61 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $251.19 Typical High $281.84 | Professional | 54 · Surgery only | $169.82 | $251.19 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $50.12 Typical High $57.54 | Professional | 55 · Aftercare only | $33.88 | $50.12 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $33.11 Typical High $38.02 | Professional | 56 · Pre-op care only | $22.91 | $33.11 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $234.42 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $158.49 | $234.42 | $269.15 |
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· 20th of 51
$398
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.