How much rates vary
Facilitymedian $1,698 · 10th to 90th $417 to $5,888Professionalmedian $380 · 10th to 90th $219 to $776
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 $218.78 Median $3,548.13 Typical High $7,585.78 | Facility | None | $218.78 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $257.04 Typical High $691.83 | Professional | None | $218.78 | $257.04 | $691.83 |
Ambetter Setting Professional Modifier None Typical Low $194.98 Median $208.93 Typical High $389.05 | Professional | None | $194.98 | $208.93 | $389.05 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $1,000.00 Typical High $5,754.40 | Facility | None | $389.05 | $1,000.00 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $239.88 Median $380.19 Typical High $776.25 | Professional | None | $239.88 | $380.19 | $776.25 |
CareSource Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $1,819.70 Typical High $2,344.23 | Facility | None | $398.11 | $1,819.70 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $489.78 Typical High $707.95 | Professional | None | $257.04 | $489.78 | $707.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $239.88 Median $295.12 Typical High $1,000.00 | Professional | None | $239.88 | $295.12 | $1,000.00 |
Oscar Health Setting Professional Modifier None Typical Low $316.23 Median $354.81 Typical High $467.74 | Professional | None | $316.23 | $354.81 | $467.74 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $7,585.78 | Facility | None | $954.99 | $1,995.26 | $7,585.78 |
United Setting Professional Modifier None Typical Low $234.42 Median $426.58 Typical High $758.58 | Professional | None | $234.42 | $426.58 | $758.58 |
8 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 $109.65 Median $109.65 Typical High $162.18 | Professional | 52 · Reduced service | $109.65 | $109.65 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $43.65 Typical High $64.57 | Professional | 53 · Discontinued | $43.65 | $43.65 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $165.96 Typical High $239.88 | Professional | 54 · Surgery only | $165.96 | $165.96 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $33.11 Typical High $47.86 | Professional | 55 · Aftercare only | $33.11 | $33.11 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $21.88 Typical High $32.36 | Professional | 56 · Pre-op care only | $21.88 | $21.88 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $154.88 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $154.88 | $154.88 | $223.87 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | 51 · Multiple procedures | $204.17 | $204.17 | $204.17 |
Ambetter Setting Professional Modifier 58 · Staged procedure Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | 58 · Staged procedure | $407.38 | $407.38 | $407.38 |
Where Georgia sits
The same service costs 4.6 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
$398
AK $891UT $195
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.