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 $758.58 Median $5,011.87 Typical High $7,943.28 | Facility | None | $758.58 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $758.58 | Professional | None | $436.52 | $436.52 | $758.58 |
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 $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 $380.19 Median $588.84 Typical High $1,000.00 | Professional | None | $380.19 | $588.84 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,995.26 Typical High $2,454.71 | Facility | None | $524.81 | $1,995.26 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $676.08 Typical High $1,174.90 | Professional | None | $478.63 | $676.08 | $1,174.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $398.11 Median $501.19 Typical High $812.83 | Professional | None | $398.11 | $501.19 | $812.83 |
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 $436.52 Median $645.65 Typical High $1,318.26 | Professional | None | $436.52 | $645.65 | $1,318.26 |
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 $218.78 Median $218.78 Typical High $257.04 | Professional | 52 · Reduced service | $218.78 | $218.78 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $87.10 Typical High $104.71 | Professional | 53 · Discontinued | $87.10 | $87.10 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $323.59 Typical High $389.05 | Professional | 54 · Surgery only | $323.59 | $323.59 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $64.57 Typical High $77.62 | Professional | 55 · Aftercare only | $64.57 | $64.57 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $43.65 Typical High $51.29 | Professional | 56 · Pre-op care only | $43.65 | $43.65 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $302.00 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $302.00 | $302.00 | $363.08 |
Where Georgia sits
The same service costs 8.9 times more in Oklahoma 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· 28th of 51
$646
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.