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 $630.96 Median $3,548.13 Typical High $7,585.78 | Facility | None | $630.96 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $676.08 | Professional | None | $457.09 | $457.09 | $676.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $851.14 Typical High $4,570.88 | Facility | None | $389.05 | $851.14 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $436.52 Median $630.96 Typical High $1,122.02 | Professional | None | $436.52 | $630.96 | $1,122.02 |
CareSource Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $1,659.59 Typical High $2,137.96 | Facility | None | $398.11 | $1,659.59 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $691.83 Typical High $1,174.90 | Professional | None | $467.74 | $691.83 | $1,174.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $501.19 Median $616.60 Typical High $954.99 | Professional | None | $501.19 | $616.60 | $954.99 |
Oscar Health Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $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 $398.11 Median $707.95 Typical High $1,380.38 | Professional | None | $398.11 | $707.95 | $1,380.38 |
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 $229.09 Median $229.09 Typical High $281.84 | Professional | 52 · Reduced service | $229.09 | $229.09 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $112.20 | Professional | 53 · Discontinued | $91.20 | $91.20 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $346.74 Typical High $416.87 | Professional | 54 · Surgery only | $346.74 | $346.74 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $83.18 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $56.23 | Professional | 56 · Pre-op care only | $45.71 | $45.71 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $323.59 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $323.59 | $323.59 | $389.05 |
Where Georgia sits
The same service costs 6.2 times more in Alaska 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· 18th of 51
$631
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.