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 $147.91 Median $3,548.13 Typical High $7,585.78 | Facility | None | $147.91 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $147.91 Typical High $389.05 | Professional | None | $107.15 | $147.91 | $389.05 |
Ambetter Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
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 $107.15 Median $194.98 Typical High $302.00 | Professional | None | $107.15 | $194.98 | $302.00 |
CareSource Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None | $100.00 | $100.00 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $131.83 Typical High $602.56 | Facility | None | $100.00 | $131.83 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $204.17 Typical High $309.03 | Professional | None | $120.23 | $204.17 | $309.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $120.23 Median $181.97 Typical High $229.09 | Professional | None | $120.23 | $181.97 | $229.09 |
Oscar Health Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
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 $112.20 Median $199.53 Typical High $380.19 | Professional | None | $112.20 | $199.53 | $380.19 |
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 $53.70 Median $74.13 Typical High $85.11 | Professional | 52 · Reduced service | $53.70 | $74.13 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $29.51 Typical High $33.88 | Professional | 53 · Discontinued | $21.38 | $29.51 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $112.20 Typical High $128.82 | Professional | 54 · Surgery only | $79.43 | $112.20 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $22.39 Typical High $25.70 | Professional | 55 · Aftercare only | $16.22 | $22.39 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $14.79 Typical High $16.98 | Professional | 56 · Pre-op care only | $10.72 | $14.79 | $16.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $104.71 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $74.13 | $104.71 | $120.23 |
Where Georgia sits
The same service costs 4.0 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
$191
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.