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 $204.17 Median $3,548.13 Typical High $7,585.78 | Facility | None | $204.17 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $269.15 Typical High $354.81 | Professional | None | $204.17 | $269.15 | $354.81 |
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 $194.98 Median $380.19 Typical High $602.56 | Professional | None | $194.98 | $380.19 | $602.56 |
CareSource Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | None | $169.82 | $169.82 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $354.81 Typical High $660.69 | Facility | None | $269.15 | $354.81 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $338.84 Typical High $630.96 | Professional | None | $204.17 | $338.84 | $630.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $223.87 Median $239.88 Typical High $457.09 | Professional | None | $223.87 | $239.88 | $457.09 |
Oscar Health Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | None | $141.25 | $141.25 | $141.25 |
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 $177.83 Median $354.81 Typical High $707.95 | Professional | None | $177.83 | $354.81 | $707.95 |
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 $102.33 Median $117.49 Typical High $177.83 | Professional | 52 · Reduced service | $102.33 | $117.49 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $47.86 Typical High $70.79 | Professional | 53 · Discontinued | $40.74 | $47.86 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $177.83 Typical High $269.15 | Professional | 54 · Surgery only | $154.88 | $177.83 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $35.48 Typical High $53.70 | Professional | 55 · Aftercare only | $30.90 | $35.48 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $23.44 Typical High $35.48 | Professional | 56 · Pre-op care only | $20.42 | $23.44 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $165.96 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $144.54 | $165.96 | $251.19 |
Where Georgia sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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
$363
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.