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 $831.76 Median $4,897.79 Typical High $7,943.28 | Facility | None | $831.76 | $4,897.79 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $1,445.44 Typical High $1,737.80 | Professional | None | $389.05 | $1,445.44 | $1,737.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $1,148.15 Typical High $5,754.40 | Facility | None | $575.44 | $1,148.15 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $501.19 Median $1,258.93 Typical High $3,801.89 | Professional | None | $501.19 | $1,258.93 | $3,801.89 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,412.54 Typical High $2,511.89 | Facility | None | $602.56 | $1,412.54 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $1,380.38 Typical High $3,801.89 | Professional | None | $436.52 | $1,380.38 | $3,801.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $416.87 Median $1,412.54 Typical High $2,818.38 | Professional | None | $416.87 | $1,412.54 | $2,818.38 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $2,884.03 Typical High $8,709.64 | Facility | None | $1,258.93 | $2,884.03 | $8,709.64 |
United Setting Professional Modifier None Typical Low $446.68 Median $1,548.82 Typical High $4,265.80 | Professional | None | $446.68 | $1,548.82 | $4,265.80 |
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 $194.98 Median $724.44 Typical High $851.14 | Professional | 52 · Reduced service | $194.98 | $724.44 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $288.40 Typical High $338.84 | Professional | 53 · Discontinued | $77.62 | $288.40 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $1,096.48 Typical High $1,288.25 | Professional | 54 · Surgery only | $288.40 | $1,096.48 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $218.78 Typical High $257.04 | Professional | 55 · Aftercare only | $57.54 | $218.78 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $144.54 Typical High $169.82 | Professional | 56 · Pre-op care only | $38.90 | $144.54 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $1,023.29 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $269.15 | $1,023.29 | $1,202.26 |
Where Georgia sits
The same service costs 4.9 times more in Alaska than in Texas. 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· 36th of 51
$1,349
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.