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 $3,630.78 Typical High $7,585.78 | Facility | None | $194.98 | $3,630.78 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $218.78 Typical High $562.34 | Professional | None | $186.21 | $218.78 | $562.34 |
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 $186.21 Median $295.12 Typical High $457.09 | Professional | None | $186.21 | $295.12 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,995.26 Typical High $2,454.71 | Facility | None | $537.03 | $1,995.26 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $302.00 Typical High $575.44 | Professional | None | $213.80 | $302.00 | $575.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $199.53 Median $257.04 Typical High $407.38 | Professional | None | $199.53 | $257.04 | $407.38 |
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 $190.55 Median $302.00 Typical High $575.44 | Professional | None | $190.55 | $302.00 | $575.44 |
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 $93.33 Median $107.15 Typical High $125.89 | Professional | 52 · Reduced service | $93.33 | $107.15 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $43.65 Typical High $51.29 | Professional | 53 · Discontinued | $37.15 | $43.65 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $162.18 Typical High $190.55 | Professional | 54 · Surgery only | $141.25 | $162.18 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $32.36 Typical High $38.02 | Professional | 55 · Aftercare only | $28.18 | $32.36 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $21.88 Typical High $25.12 | Professional | 56 · Pre-op care only | $18.62 | $21.88 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $151.36 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $131.83 | $151.36 | $177.83 |
Where Georgia sits
The same service costs 5.9 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· 22nd of 51
$309
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.