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 $239.88 Median $3,548.13 Typical High $7,585.78 | Facility | None | $239.88 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $239.88 Typical High $269.15 | Professional | None | $144.54 | $239.88 | $269.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $831.76 Typical High $4,570.88 | Facility | None | $389.05 | $831.76 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $141.25 Median $295.12 Typical High $467.74 | Professional | None | $141.25 | $295.12 | $467.74 |
CareSource Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $218.78 Typical High $602.56 | Facility | None | $165.96 | $218.78 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $269.15 Typical High $467.74 | Professional | None | $158.49 | $269.15 | $467.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $151.36 Median $275.42 Typical High $346.74 | Professional | None | $151.36 | $275.42 | $346.74 |
Oscar Health Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
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 $147.91 Median $275.42 Typical High $524.81 | Professional | None | $147.91 | $275.42 | $524.81 |
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 $70.79 Median $117.49 Typical High $134.90 | Professional | 52 · Reduced service | $70.79 | $117.49 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $46.77 Typical High $53.70 | Professional | 53 · Discontinued | $28.84 | $46.77 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $173.78 Typical High $199.53 | Professional | 54 · Surgery only | $107.15 | $173.78 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $35.48 Typical High $39.81 | Professional | 55 · Aftercare only | $21.38 | $35.48 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $23.44 Typical High $26.92 | Professional | 56 · Pre-op care only | $14.45 | $23.44 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $162.18 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $100.00 | $162.18 | $186.21 |
Where Georgia sits
The same service costs 3.5 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
$295
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.