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 $186.21 Median $5,370.32 Typical High $7,585.78 | Facility | None | $186.21 | $5,370.32 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $323.59 Typical High $812.83 | Professional | None | $186.21 | $323.59 | $812.83 |
Ambetter Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | None | $575.44 | $575.44 | $575.44 |
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 $151.36 Median $302.00 Typical High $575.44 | Professional | None | $151.36 | $302.00 | $575.44 |
CareSource Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $389.05 Typical High $1,513.56 | Facility | None | $295.12 | $389.05 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $338.84 Typical High $707.95 | Professional | None | $186.21 | $338.84 | $707.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $229.09 Median $251.19 Typical High $478.63 | Professional | None | $229.09 | $251.19 | $478.63 |
Oscar Health Setting Professional Modifier None Typical Low $263.03 Median $407.38 Typical High $676.08 | Professional | None | $263.03 | $407.38 | $676.08 |
United Setting Facility Modifier None Typical Low $331.13 Median $501.19 Typical High $2,454.71 | Facility | None | $331.13 | $501.19 | $2,454.71 |
United Setting Professional Modifier None Typical Low $158.49 Median $331.13 Typical High $794.33 | Professional | None | $158.49 | $331.13 | $794.33 |
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 $93.33 Median $109.65 Typical High $177.83 | Professional | 52 · Reduced service | $93.33 | $109.65 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $43.65 Typical High $70.79 | Professional | 53 · Discontinued | $38.02 | $43.65 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $162.18 Typical High $269.15 | Professional | 54 · Surgery only | $141.25 | $162.18 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $32.36 Typical High $53.70 | Professional | 55 · Aftercare only | $28.18 | $32.36 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $21.88 Typical High $35.48 | Professional | 56 · Pre-op care only | $18.62 | $21.88 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $151.36 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $131.83 | $151.36 | $251.19 |
Where Georgia sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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
$324
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.