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 $371.54 Median $4,466.84 Typical High $7,585.78 | Facility | None | $371.54 | $4,466.84 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $371.54 Typical High $501.19 | Professional | None | $269.15 | $371.54 | $501.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $512.86 Median $1,000.00 Typical High $4,570.88 | Facility | None | $512.86 | $1,000.00 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $263.03 Median $478.63 Typical High $776.25 | Professional | None | $263.03 | $478.63 | $776.25 |
CareSource Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,698.24 Typical High $2,187.76 | Facility | None | $524.81 | $1,698.24 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $501.19 Typical High $758.58 | Professional | None | $302.00 | $501.19 | $758.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $288.40 Median $446.68 Typical High $707.95 | Professional | None | $288.40 | $446.68 | $707.95 |
Oscar Health Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
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 $281.84 Median $478.63 Typical High $912.01 | Professional | None | $281.84 | $478.63 | $912.01 |
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 $131.83 Median $186.21 Typical High $213.80 | Professional | 52 · Reduced service | $131.83 | $186.21 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $74.13 Typical High $85.11 | Professional | 53 · Discontinued | $53.70 | $74.13 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $275.42 Typical High $316.23 | Professional | 54 · Surgery only | $199.53 | $275.42 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $54.95 Typical High $63.10 | Professional | 55 · Aftercare only | $39.81 | $54.95 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $37.15 Typical High $42.66 | Professional | 56 · Pre-op care only | $26.92 | $37.15 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $257.04 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $186.21 | $257.04 | $295.12 |
Where Georgia sits
The same service costs 4.1 times more in Alaska than in New Jersey. 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· 14th of 51
$479
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.