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 $112.20 Median $5,370.32 Typical High $7,585.78 | Facility | None | $112.20 | $5,370.32 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $147.91 Typical High $309.03 | Professional | None | $112.20 | $147.91 | $309.03 |
Ambetter Setting Professional Modifier None Typical Low $131.83 Median $263.03 Typical High $281.84 | Professional | None | $131.83 | $263.03 | $281.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $380.19 Median $776.25 Typical High $3,630.78 | Facility | None | $380.19 | $776.25 | $3,630.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $107.15 Median $190.55 Typical High $316.23 | Professional | None | $107.15 | $190.55 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $346.74 Typical High $4,265.80 | Facility | None | $50.12 | $346.74 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $186.21 Typical High $371.54 | Professional | None | $125.89 | $186.21 | $371.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $117.49 Median $169.82 Typical High $208.93 | Professional | None | $117.49 | $169.82 | $208.93 |
United Setting Facility Modifier None Typical Low $79.43 Median $158.49 Typical High $1,778.28 | Facility | None | $79.43 | $158.49 | $1,778.28 |
United Setting Professional Modifier None Typical Low $112.20 Median $181.97 Typical High $346.74 | Professional | None | $112.20 | $181.97 | $346.74 |
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 $56.23 Median $70.79 Typical High $85.11 | Professional | 52 · Reduced service | $56.23 | $70.79 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $28.18 Typical High $33.88 | Professional | 53 · Discontinued | $22.39 | $28.18 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $107.15 Typical High $128.82 | Professional | 54 · Surgery only | $85.11 | $107.15 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $21.38 Typical High $25.70 | Professional | 55 · Aftercare only | $16.98 | $21.38 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $14.13 Typical High $16.98 | Professional | 56 · Pre-op care only | $11.22 | $14.13 | $16.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $100.00 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $79.43 | $100.00 | $120.23 |
Where Georgia sits
The same service costs 4.1 times more in Alaska 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· 18th of 51
$186
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.