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 $263.03 Median $4,897.79 Typical High $7,943.28 | Facility | None | $263.03 | $4,897.79 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $263.03 Typical High $691.83 | Professional | None | $165.96 | $263.03 | $691.83 |
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 $158.49 Median $331.13 Typical High $549.54 | Professional | None | $158.49 | $331.13 | $549.54 |
CareSource Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $245.47 Typical High $776.25 | Facility | None | $181.97 | $245.47 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $331.13 Typical High $524.81 | Professional | None | $190.55 | $331.13 | $524.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $177.83 Median $309.03 Typical High $512.86 | Professional | None | $177.83 | $309.03 | $512.86 |
Oscar Health Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
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 $173.78 Median $309.03 Typical High $588.84 | Professional | None | $173.78 | $309.03 | $588.84 |
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 $83.18 Median $131.83 Typical High $147.91 | Professional | 52 · Reduced service | $83.18 | $131.83 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $52.48 Typical High $60.26 | Professional | 53 · Discontinued | $33.11 | $52.48 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $199.53 Typical High $223.87 | Professional | 54 · Surgery only | $123.03 | $199.53 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $39.81 Typical High $44.67 | Professional | 55 · Aftercare only | $24.55 | $39.81 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $26.30 Typical High $30.20 | Professional | 56 · Pre-op care only | $16.60 | $26.30 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $186.21 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $114.82 | $186.21 | $208.93 |
Where Georgia sits
The same service costs 3.6 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· 13th of 51
$331
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.