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 $3,548.13 Typical High $7,585.78 | Facility | None | $263.03 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $263.03 Typical High $295.12 | Professional | None | $173.78 | $263.03 | $295.12 |
Ambetter Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $380.19 Median $776.25 Typical High $3,630.78 | Facility | None | $380.19 | $776.25 | $3,630.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $173.78 Median $346.74 Typical High $537.03 | Professional | None | $173.78 | $346.74 | $537.03 |
CareSource Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $380.19 Typical High $660.69 | Facility | None | $295.12 | $380.19 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $338.84 Typical High $549.54 | Professional | None | $190.55 | $338.84 | $549.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $190.55 Median $316.23 Typical High $371.54 | Professional | None | $190.55 | $316.23 | $371.54 |
Oscar Health Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
United Setting Facility Modifier None Typical Low $79.43 Median $158.49 Typical High $1,778.28 | Facility | None | $79.43 | $158.49 | $1,778.28 |
United Setting Professional Modifier None Typical Low $181.97 Median $323.59 Typical High $616.60 | Professional | None | $181.97 | $323.59 | $616.60 |
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 $87.10 Median $131.83 Typical High $147.91 | Professional | 52 · Reduced service | $87.10 | $131.83 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $52.48 Typical High $58.88 | Professional | 53 · Discontinued | $35.48 | $52.48 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $194.98 Typical High $218.78 | Professional | 54 · Surgery only | $131.83 | $194.98 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $39.81 Typical High $43.65 | Professional | 55 · Aftercare only | $26.30 | $39.81 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $26.30 Typical High $29.51 | Professional | 56 · Pre-op care only | $17.38 | $26.30 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $181.97 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $123.03 | $181.97 | $204.17 |
Where Georgia sits
The same service costs 4.2 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· 15th 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.