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 $302.00 Median $4,466.84 Typical High $7,585.78 | Facility | None | $302.00 | $4,466.84 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $302.00 Typical High $794.33 | Professional | None | $223.87 | $302.00 | $794.33 |
Ambetter Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | None | $602.56 | $602.56 | $602.56 |
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 $218.78 Median $407.38 Typical High $630.96 | Professional | None | $218.78 | $407.38 | $630.96 |
CareSource Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $794.33 Typical High $1,023.29 | Facility | None | $524.81 | $794.33 | $1,023.29 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $407.38 Typical High $645.65 | Professional | None | $245.47 | $407.38 | $645.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $239.88 Median $380.19 Typical High $436.52 | Professional | None | $239.88 | $380.19 | $436.52 |
Oscar Health Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
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 $234.42 Median $407.38 Typical High $776.25 | Professional | None | $234.42 | $407.38 | $776.25 |
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 $112.20 Median $151.36 Typical High $169.82 | Professional | 52 · Reduced service | $112.20 | $151.36 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $60.26 Typical High $69.18 | Professional | 53 · Discontinued | $44.67 | $60.26 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $229.09 Typical High $257.04 | Professional | 54 · Surgery only | $165.96 | $229.09 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $45.71 Typical High $51.29 | Professional | 55 · Aftercare only | $33.88 | $45.71 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $30.20 Typical High $33.88 | Professional | 56 · Pre-op care only | $22.39 | $30.20 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $213.80 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $154.88 | $213.80 | $239.88 |
Where Georgia sits
The same service costs 4.3 times more in Alaska than in Utah. 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
$407
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.