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 $97.72 Median $5,370.32 Typical High $7,585.78 | Facility | None | $97.72 | $5,370.32 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $138.04 Typical High $302.00 | Professional | None | $97.72 | $138.04 | $302.00 |
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 $109.65 Median $158.49 Typical High $295.12 | Professional | None | $109.65 | $158.49 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $93.33 Median $125.89 Typical High $1,513.56 | Facility | None | $93.33 | $125.89 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $165.96 Typical High $331.13 | Professional | None | $107.15 | $165.96 | $331.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $102.33 Median $154.88 Typical High $239.88 | Professional | None | $102.33 | $154.88 | $239.88 |
United Setting Facility Modifier None Typical Low $501.19 Median $724.44 Typical High $3,548.13 | Facility | None | $501.19 | $724.44 | $3,548.13 |
United Setting Professional Modifier None Typical Low $95.50 Median $158.49 Typical High $323.59 | Professional | None | $95.50 | $158.49 | $323.59 |
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 $48.98 Median $63.10 Typical High $87.10 | Professional | 52 · Reduced service | $48.98 | $63.10 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $25.12 Typical High $34.67 | Professional | 53 · Discontinued | $19.50 | $25.12 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $93.33 Typical High $128.82 | Professional | 54 · Surgery only | $72.44 | $93.33 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $19.05 Typical High $25.70 | Professional | 55 · Aftercare only | $14.79 | $19.05 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $12.59 Typical High $17.38 | Professional | 56 · Pre-op care only | $9.77 | $12.59 | $17.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $67.61 Median $87.10 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $67.61 | $87.10 | $120.23 |
Where Georgia sits
The same service costs 3.5 times more in Wisconsin than in Kentucky. 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· 20th of 51
$170
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.