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 $1,659.59 Median $7,244.36 Typical High $15,488.17 | Facility | None | $1,659.59 | $7,244.36 | $15,488.17 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $891.25 Typical High $2,089.30 | Professional | None | $776.25 | $891.25 | $2,089.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $794.33 Median $1,584.89 Typical High $8,912.51 | Facility | None | $794.33 | $1,584.89 | $8,912.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $676.08 Median $1,047.13 Typical High $1,778.28 | Professional | None | $676.08 | $1,047.13 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,174.90 Median $1,584.89 Typical High $2,951.21 | Professional | 50 · Both sides | $1,174.90 | $1,584.89 | $2,951.21 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $3,467.37 Typical High $4,365.16 | Facility | None | $812.83 | $3,467.37 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,230.27 Typical High $2,089.30 | Professional | None | $870.96 | $1,230.27 | $2,089.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $691.83 Median $870.96 Typical High $1,659.59 | Professional | None | $691.83 | $870.96 | $1,659.59 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $3,715.35 Typical High $9,549.93 | Facility | None | $1,513.56 | $3,715.35 | $9,549.93 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,174.90 Typical High $2,137.96 | Professional | None | $794.33 | $1,174.90 | $2,137.96 |
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 $389.05 Median $389.05 Typical High $501.19 | Professional | 52 · Reduced service | $389.05 | $389.05 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $199.53 | Professional | 53 · Discontinued | $154.88 | $154.88 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $758.58 | Professional | 54 · Surgery only | $588.84 | $588.84 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $151.36 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $100.00 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $549.54 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $549.54 | $549.54 | $707.95 |
Where Georgia sits
The same service costs 7.2 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· 24th of 51
$1,122
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.