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 $478.63 Median $5,370.32 Typical High $8,317.64 | Facility | None | $478.63 | $5,370.32 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $263.03 Typical High $660.69 | Professional | None | $239.88 | $263.03 | $660.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $660.69 Median $1,202.26 Typical High $4,570.88 | Facility | None | $660.69 | $1,202.26 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $346.74 Typical High $537.03 | Professional | None | $204.17 | $346.74 | $537.03 |
CareSource Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,698.24 Typical High $2,344.23 | Facility | None | $741.31 | $1,698.24 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $389.05 Typical High $645.65 | Professional | None | $263.03 | $389.05 | $645.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $263.03 Median $316.23 Typical High $616.60 | Professional | None | $263.03 | $316.23 | $616.60 |
Oscar Health Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
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 $229.09 Median $398.11 Typical High $776.25 | Professional | None | $229.09 | $398.11 | $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 $120.23 Median $120.23 Typical High $158.49 | Professional | 52 · Reduced service | $120.23 | $120.23 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $47.86 Typical High $63.10 | Professional | 53 · Discontinued | $47.86 | $47.86 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $181.97 Typical High $234.42 | Professional | 54 · Surgery only | $181.97 | $181.97 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $36.31 Typical High $46.77 | Professional | 55 · Aftercare only | $36.31 | $36.31 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $23.99 Typical High $31.62 | Professional | 56 · Pre-op care only | $23.99 | $23.99 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $169.82 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $169.82 | $169.82 | $218.78 |
Where Georgia sits
The same service costs 6.0 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· 20th of 51
$355
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.