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 $239.88 Median $3,548.13 Typical High $7,585.78 | Facility | None | $239.88 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $245.47 Typical High $645.65 | Professional | None | $134.90 | $245.47 | $645.65 |
Ambetter Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
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 $134.90 Median $281.84 Typical High $489.78 | Professional | None | $134.90 | $281.84 | $489.78 |
CareSource Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $263.03 Typical High $645.65 | Facility | None | $199.53 | $263.03 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $295.12 Typical High $549.54 | Professional | None | $154.88 | $295.12 | $549.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $154.88 Median $309.03 Typical High $354.81 | Professional | None | $154.88 | $309.03 | $354.81 |
Oscar Health Setting Professional Modifier None Typical Low $213.80 Median $380.19 Typical High $512.86 | Professional | None | $213.80 | $380.19 | $512.86 |
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 $141.25 Median $269.15 Typical High $588.84 | Professional | None | $141.25 | $269.15 | $588.84 |
7 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 $67.61 Median $120.23 Typical High $134.90 | Professional | 52 · Reduced service | $67.61 | $120.23 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $47.86 Typical High $53.70 | Professional | 53 · Discontinued | $26.92 | $47.86 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $181.97 Typical High $204.17 | Professional | 54 · Surgery only | $100.00 | $181.97 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $36.31 Typical High $40.74 | Professional | 55 · Aftercare only | $20.42 | $36.31 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $23.99 Typical High $26.92 | Professional | 56 · Pre-op care only | $13.49 | $23.99 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $169.82 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $93.33 | $169.82 | $190.55 |
Ambetter Setting Professional Modifier 58 · Staged procedure Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | 58 · Staged procedure | $302.00 | $302.00 | $302.00 |
Where Georgia sits
The same service costs 3.5 times more in Alaska than in Washington, DC. 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
$275
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.