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 $5,370.32 Typical High $7,943.28 | Facility | None | $831.76 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $478.63 Typical High $891.25 | Professional | None | $416.87 | $478.63 | $891.25 |
Ambetter Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | None | $741.31 | $741.31 | $741.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $562.34 Median $1,071.52 Typical High $4,570.88 | Facility | None | $562.34 | $1,071.52 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $371.54 Median $575.44 Typical High $977.24 | Professional | None | $371.54 | $575.44 | $977.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $616.60 Median $851.14 Typical High $1,584.89 | Professional | 50 · Both sides | $616.60 | $851.14 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,995.26 Typical High $2,630.27 | Facility | None | $602.56 | $1,995.26 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $630.96 Typical High $1,148.15 | Professional | None | $467.74 | $630.96 | $1,148.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $389.05 Median $478.63 Typical High $776.25 | Professional | None | $389.05 | $478.63 | $776.25 |
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 $426.58 Median $602.56 Typical High $1,148.15 | Professional | None | $426.58 | $602.56 | $1,148.15 |
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 $208.93 Median $208.93 Typical High $269.15 | Professional | 52 · Reduced service | $208.93 | $208.93 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $85.11 Typical High $107.15 | Professional | 53 · Discontinued | $85.11 | $85.11 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $316.23 Typical High $407.38 | Professional | 54 · Surgery only | $316.23 | $316.23 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $81.28 | Professional | 55 · Aftercare only | $63.10 | $63.10 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $41.69 Typical High $53.70 | Professional | 56 · Pre-op care only | $41.69 | $41.69 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $295.12 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $295.12 | $295.12 | $380.19 |
Where Georgia sits
The same service costs 6.0 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· 27th of 51
$631
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.