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 $467.74 Median $4,466.84 Typical High $7,585.78 | Facility | None | $467.74 | $4,466.84 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $467.74 Typical High $549.54 | Professional | None | $331.13 | $467.74 | $549.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $512.86 Median $1,174.90 Typical High $7,244.36 | Facility | None | $512.86 | $1,174.90 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $323.59 Median $602.56 Typical High $977.24 | Professional | None | $323.59 | $602.56 | $977.24 |
CareSource Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $3,388.44 Typical High $4,265.80 | Facility | None | $524.81 | $3,388.44 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $616.60 Typical High $933.25 | Professional | None | $380.19 | $616.60 | $933.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $354.81 Median $575.44 Typical High $870.96 | Professional | None | $354.81 | $575.44 | $870.96 |
Oscar Health Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | None | $426.58 | $426.58 | $426.58 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,479.11 Typical High $5,011.87 | Facility | None | $851.14 | $1,479.11 | $5,011.87 |
United Setting Professional Modifier None Typical Low $346.74 Median $602.56 Typical High $1,122.02 | Professional | None | $346.74 | $602.56 | $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 $165.96 Median $234.42 Typical High $269.15 | Professional | 52 · Reduced service | $165.96 | $234.42 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $95.50 Typical High $107.15 | Professional | 53 · Discontinued | $67.61 | $95.50 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $354.81 Typical High $398.11 | Professional | 54 · Surgery only | $251.19 | $354.81 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $70.79 Typical High $79.43 | Professional | 55 · Aftercare only | $50.12 | $70.79 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $46.77 Typical High $53.70 | Professional | 56 · Pre-op care only | $33.11 | $46.77 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $331.13 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $234.42 | $331.13 | $371.54 |
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· 15th of 51
$589
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.