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 $194.98 Median $3,548.13 Typical High $7,585.78 | Facility | None | $194.98 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $194.98 Typical High $263.03 | Professional | None | $169.82 | $194.98 | $263.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $512.86 Median $1,000.00 Typical High $4,570.88 | Facility | None | $512.86 | $1,000.00 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $263.03 Typical High $416.87 | Professional | None | $169.82 | $263.03 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $120.23 Typical High $1,513.56 | Facility | None | $89.13 | $120.23 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $269.15 Typical High $512.86 | Professional | None | $186.21 | $269.15 | $512.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $177.83 Median $229.09 Typical High $346.74 | Professional | None | $177.83 | $229.09 | $346.74 |
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 $173.78 Median $269.15 Typical High $512.86 | Professional | None | $173.78 | $269.15 | $512.86 |
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 $85.11 Median $97.72 Typical High $114.82 | Professional | 52 · Reduced service | $85.11 | $97.72 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $38.90 Typical High $45.71 | Professional | 53 · Discontinued | $33.88 | $38.90 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $144.54 Typical High $169.82 | Professional | 54 · Surgery only | $128.82 | $144.54 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $29.51 Typical High $33.88 | Professional | 55 · Aftercare only | $25.70 | $29.51 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $19.50 Typical High $22.91 | Professional | 56 · Pre-op care only | $16.98 | $19.50 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $134.90 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $120.23 | $134.90 | $158.49 |
Where Georgia sits
The same service costs 4.9 times more in Oklahoma than in Florida. 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· 24th of 51
$263
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.