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 $3,019.95 Typical High $7,413.10 | Facility | None | $112.20 | $3,019.95 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $158.49 Typical High $323.59 | Professional | None | $89.13 | $158.49 | $323.59 |
Ambetter Setting Professional Modifier None Typical Low $186.21 Median $323.59 Typical High $354.81 | Professional | None | $186.21 | $323.59 | $354.81 |
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 $109.65 Median $190.55 Typical High $331.13 | Professional | None | $109.65 | $190.55 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $147.91 Typical High $602.56 | Facility | None | $112.20 | $147.91 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $177.83 Typical High $398.11 | Professional | None | $100.00 | $177.83 | $398.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $112.20 Median $204.17 Typical High $257.04 | Professional | None | $112.20 | $204.17 | $257.04 |
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 $107.15 Median $181.97 Typical High $407.38 | Professional | None | $107.15 | $181.97 | $407.38 |
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 $44.67 Median $72.44 Typical High $91.20 | Professional | 52 · Reduced service | $44.67 | $72.44 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $28.84 Typical High $36.31 | Professional | 53 · Discontinued | $17.78 | $28.84 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $107.15 Typical High $138.04 | Professional | 54 · Surgery only | $66.07 | $107.15 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $21.88 Typical High $27.54 | Professional | 55 · Aftercare only | $13.18 | $21.88 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $14.45 Typical High $18.20 | Professional | 56 · Pre-op care only | $8.91 | $14.45 | $18.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $61.66 Median $100.00 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $61.66 | $100.00 | $128.82 |
Where Georgia sits
The same service costs 3.6 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· 21st of 51
$195
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.