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 $223.87 Median $3,548.13 Typical High $7,585.78 | Facility | None | $223.87 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $234.42 Typical High $575.44 | Professional | None | $128.82 | $234.42 | $575.44 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $218.78 | Professional | None | $114.82 | $114.82 | $218.78 |
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 $162.18 Median $269.15 Typical High $426.58 | Professional | None | $162.18 | $269.15 | $426.58 |
CareSource Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $223.87 Typical High $602.56 | Facility | None | $169.82 | $223.87 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $251.19 Typical High $478.63 | Professional | None | $144.54 | $251.19 | $478.63 |
Kaiser Permanente Setting Professional Modifier None Typical Low $141.25 Median $263.03 Typical High $316.23 | Professional | None | $141.25 | $263.03 | $316.23 |
Oscar Health Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
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 $134.90 Median $245.47 Typical High $501.19 | Professional | None | $134.90 | $245.47 | $501.19 |
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 $64.57 Median $112.20 Typical High $128.82 | Professional | 52 · Reduced service | $64.57 | $112.20 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $44.67 Typical High $51.29 | Professional | 53 · Discontinued | $25.70 | $44.67 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $165.96 Typical High $194.98 | Professional | 54 · Surgery only | $97.72 | $165.96 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $33.88 Typical High $38.90 | Professional | 55 · Aftercare only | $19.50 | $33.88 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $22.39 Typical High $25.70 | Professional | 56 · Pre-op care only | $12.88 | $22.39 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $154.88 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $91.20 | $154.88 | $181.97 |
Where Georgia sits
The same service costs 3.3 times more in Alaska than in Washington, DC. 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· 13th of 51
$269
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.