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 $295.12 Median $5,370.32 Typical High $7,585.78 | Facility | None | $295.12 | $5,370.32 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $467.74 Typical High $537.03 | Professional | None | $295.12 | $467.74 | $537.03 |
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 $316.23 Median $537.03 Typical High $954.99 | Professional | None | $316.23 | $537.03 | $954.99 |
CareSource Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | None | $275.42 | $275.42 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $524.81 Typical High $1,513.56 | Facility | None | $398.11 | $524.81 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $524.81 Typical High $977.24 | Professional | None | $295.12 | $524.81 | $977.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $354.81 Median $602.56 Typical High $794.33 | Professional | None | $354.81 | $602.56 | $794.33 |
Oscar Health Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $2,884.03 Typical High $8,709.64 | Facility | None | $1,258.93 | $2,884.03 | $8,709.64 |
United Setting Professional Modifier None Typical Low $295.12 Median $549.54 Typical High $1,122.02 | Professional | None | $295.12 | $549.54 | $1,122.02 |
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 $147.91 Median $229.09 Typical High $269.15 | Professional | 52 · Reduced service | $147.91 | $229.09 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $91.20 Typical High $107.15 | Professional | 53 · Discontinued | $60.26 | $91.20 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $338.84 Typical High $398.11 | Professional | 54 · Surgery only | $223.87 | $338.84 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $69.18 Typical High $79.43 | Professional | 55 · Aftercare only | $44.67 | $69.18 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $45.71 Typical High $53.70 | Professional | 56 · Pre-op care only | $29.51 | $45.71 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $316.23 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $208.93 | $316.23 | $371.54 |
Where Georgia sits
The same service costs 4.3 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· 20th of 51
$513
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.