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 $269.15 Median $3,630.78 Typical High $7,413.10 | Facility | None | $269.15 | $3,630.78 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $371.54 Typical High $977.24 | Professional | None | $234.42 | $371.54 | $977.24 |
Ambetter Setting Professional Modifier None Typical Low $316.23 Median $446.68 Typical High $676.08 | Professional | None | $316.23 | $446.68 | $676.08 |
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 $275.42 Median $436.52 Typical High $707.95 | Professional | None | $275.42 | $436.52 | $707.95 |
CareSource Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $436.52 | Professional | None | $398.11 | $398.11 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,174.90 Typical High $1,548.82 | Facility | None | $537.03 | $1,174.90 | $1,548.82 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $478.63 Typical High $891.25 | Professional | None | $263.03 | $478.63 | $891.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $257.04 Median $407.38 Typical High $691.83 | Professional | None | $257.04 | $407.38 | $691.83 |
Oscar Health Setting Facility Modifier None Typical Low $870.96 Median $4,570.88 Typical High $6,918.31 | Facility | None | $870.96 | $4,570.88 | $6,918.31 |
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 $239.88 Median $467.74 Typical High $954.99 | Professional | None | $239.88 | $467.74 | $954.99 |
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 $117.49 Median $165.96 Typical High $213.80 | Professional | 52 · Reduced service | $117.49 | $165.96 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $66.07 Typical High $85.11 | Professional | 53 · Discontinued | $46.77 | $66.07 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $251.19 Typical High $323.59 | Professional | 54 · Surgery only | $177.83 | $251.19 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $50.12 Typical High $64.57 | Professional | 55 · Aftercare only | $35.48 | $50.12 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $33.11 Typical High $42.66 | Professional | 56 · Pre-op care only | $23.44 | $33.11 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $234.42 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $165.96 | $234.42 | $302.00 |
Where Georgia sits
The same service costs 4.6 times more in Alaska 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
$457
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.