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 $2,344.23 Median $5,370.32 Typical High $7,943.28 | Facility | None | $2,344.23 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,754.23 | Professional | None | $2,344.23 | $2,344.23 | $2,754.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,862.09 Typical High $8,128.31 | Facility | None | $588.84 | $1,862.09 | $8,128.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,041.74 Median $2,818.38 Typical High $7,244.36 | Professional | None | $2,041.74 | $2,818.38 | $7,244.36 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,318.26 Median $3,090.30 Typical High $7,413.10 | Professional | 62 · Two surgeons | $1,318.26 | $3,090.30 | $7,413.10 |
CareSource Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,548.82 | $1,548.82 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $549.54 Typical High $2,398.83 | Facility | None | $457.09 | $549.54 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $2,570.40 Median $4,073.80 Typical High $7,943.28 | Professional | None | $2,570.40 | $4,073.80 | $7,943.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,949.84 Median $2,884.03 Typical High $18,197.01 | Professional | None | $1,949.84 | $2,884.03 | $18,197.01 |
Oscar Health Setting Professional Modifier None Typical Low $1,548.82 Median $2,754.23 Typical High $2,754.23 | Professional | None | $1,548.82 | $2,754.23 | $2,754.23 |
United Setting Facility Modifier None Typical Low $371.54 Median $645.65 Typical High $3,981.07 | Facility | None | $371.54 | $645.65 | $3,981.07 |
United Setting Professional Modifier None Typical Low $1,949.84 Median $3,801.89 Typical High $7,244.36 | Professional | None | $1,949.84 | $3,801.89 | $7,244.36 |
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 $1,174.90 Median $1,174.90 Typical High $1,380.38 | Professional | 52 · Reduced service | $1,174.90 | $1,174.90 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $467.74 Typical High $549.54 | Professional | 53 · Discontinued | $467.74 | $467.74 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $1,778.28 Typical High $2,089.30 | Professional | 54 · Surgery only | $1,778.28 | $1,778.28 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $354.81 Typical High $416.87 | Professional | 55 · Aftercare only | $354.81 | $354.81 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $234.42 Typical High $275.42 | Professional | 56 · Pre-op care only | $234.42 | $234.42 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $1,659.59 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,659.59 | $1,659.59 | $1,949.84 |
Where Georgia sits
The same service costs 18.2 times more in Alaska than in New York. 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· 18th of 51
$2,884
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.