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 $194.98 Median $3,548.13 Typical High $7,585.78 | Facility | None | $194.98 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $204.17 Typical High $524.81 | Professional | None | $151.36 | $204.17 | $524.81 |
Ambetter Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | None | $169.82 | $169.82 | $169.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $851.14 Typical High $4,570.88 | Facility | None | $389.05 | $851.14 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $186.21 Median $309.03 Typical High $501.19 | Professional | None | $186.21 | $309.03 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $1,949.84 Typical High $2,454.71 | Facility | None | $398.11 | $1,949.84 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $316.23 Typical High $575.44 | Professional | None | $186.21 | $316.23 | $575.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $186.21 Median $269.15 Typical High $467.74 | Professional | None | $186.21 | $269.15 | $467.74 |
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 $186.21 Median $288.40 Typical High $537.03 | Professional | None | $186.21 | $288.40 | $537.03 |
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 $75.86 Median $97.72 Typical High $128.82 | Professional | 52 · Reduced service | $75.86 | $97.72 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $38.90 Typical High $51.29 | Professional | 53 · Discontinued | $30.20 | $38.90 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $147.91 Typical High $194.98 | Professional | 54 · Surgery only | $112.20 | $147.91 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $29.51 Typical High $38.90 | Professional | 55 · Aftercare only | $22.39 | $29.51 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $19.50 Typical High $25.70 | Professional | 56 · Pre-op care only | $15.14 | $19.50 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $138.04 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $104.71 | $138.04 | $181.97 |
Where Georgia sits
The same service costs 4.4 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· 18th of 51
$324
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.