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 $218.78 Median $3,548.13 Typical High $7,585.78 | Facility | None | $218.78 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $218.78 Typical High $245.47 | Professional | None | $154.88 | $218.78 | $245.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $851.14 Typical High $4,570.88 | Facility | None | $389.05 | $851.14 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $151.36 Median $281.84 Typical High $446.68 | Professional | None | $151.36 | $281.84 | $446.68 |
CareSource Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | None | $141.25 | $141.25 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $758.58 Typical High $1,000.00 | Facility | None | $398.11 | $758.58 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $281.84 Typical High $457.09 | Professional | None | $165.96 | $281.84 | $457.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $165.96 Median $263.03 Typical High $309.03 | Professional | None | $165.96 | $263.03 | $309.03 |
Oscar Health Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
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 $158.49 Median $275.42 Typical High $537.03 | Professional | None | $158.49 | $275.42 | $537.03 |
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 $75.86 Median $109.65 Typical High $123.03 | Professional | 52 · Reduced service | $75.86 | $109.65 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $43.65 Typical High $48.98 | Professional | 53 · Discontinued | $30.90 | $43.65 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $162.18 Typical High $181.97 | Professional | 54 · Surgery only | $114.82 | $162.18 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $32.36 Typical High $36.31 | Professional | 55 · Aftercare only | $22.91 | $32.36 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $21.88 Typical High $24.55 | Professional | 56 · Pre-op care only | $15.49 | $21.88 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $151.36 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $107.15 | $151.36 | $169.82 |
Where Georgia sits
The same service costs 4.2 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
$282
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.