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 $354.81 Median $3,548.13 Typical High $7,585.78 | Facility | None | $354.81 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $354.81 Typical High $407.38 | Professional | None | $218.78 | $354.81 | $407.38 |
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 $218.78 Median $436.52 Typical High $660.69 | Professional | None | $218.78 | $436.52 | $660.69 |
CareSource Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $257.04 Median $346.74 Typical High $1,513.56 | Facility | None | $257.04 | $346.74 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $426.58 Typical High $741.31 | Professional | None | $229.09 | $426.58 | $741.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $234.42 Median $446.68 Typical High $794.33 | Professional | None | $234.42 | $446.68 | $794.33 |
Oscar Health Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
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 $234.42 Median $407.38 Typical High $831.76 | Professional | None | $234.42 | $407.38 | $831.76 |
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 $109.65 Median $173.78 Typical High $204.17 | Professional | 52 · Reduced service | $109.65 | $173.78 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $69.18 Typical High $81.28 | Professional | 53 · Discontinued | $44.67 | $69.18 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $263.03 Typical High $309.03 | Professional | 54 · Surgery only | $165.96 | $263.03 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $52.48 Typical High $61.66 | Professional | 55 · Aftercare only | $33.11 | $52.48 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $34.67 Typical High $40.74 | Professional | 56 · Pre-op care only | $21.88 | $34.67 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $245.47 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $154.88 | $245.47 | $288.40 |
Where Georgia sits
The same service costs 3.6 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· 13th of 51
$427
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.