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 $123.03 Median $4,897.79 Typical High $7,585.78 | Facility | None | $123.03 | $4,897.79 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $131.83 Typical High $346.74 | Professional | None | $91.20 | $131.83 | $346.74 |
Ambetter Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
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 $117.49 Median $213.80 Typical High $338.84 | Professional | None | $117.49 | $213.80 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $120.23 Typical High $1,513.56 | Facility | None | $91.20 | $120.23 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $199.53 Typical High $380.19 | Professional | None | $117.49 | $199.53 | $380.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $114.82 Median $186.21 Typical High $269.15 | Professional | None | $114.82 | $186.21 | $269.15 |
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 $120.23 Median $194.98 Typical High $363.08 | Professional | None | $120.23 | $194.98 | $363.08 |
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 $45.71 Median $66.07 Typical High $87.10 | Professional | 52 · Reduced service | $45.71 | $66.07 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $26.30 Typical High $34.67 | Professional | 53 · Discontinued | $18.20 | $26.30 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $100.00 Typical High $131.83 | Professional | 54 · Surgery only | $69.18 | $100.00 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $19.95 Typical High $26.30 | Professional | 55 · Aftercare only | $13.80 | $19.95 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $13.18 Typical High $17.38 | Professional | 56 · Pre-op care only | $9.12 | $13.18 | $17.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $64.57 Median $93.33 Typical High $123.03 | Professional | 78 · Unplanned return to OR | $64.57 | $93.33 | $123.03 |
Where Georgia sits
The same service costs 3.6 times more in Wisconsin than in Texas. 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· 13th of 51
$224
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.