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 $549.54 Median $3,548.13 Typical High $7,585.78 | Facility | None | $549.54 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $363.08 Typical High $549.54 | Professional | None | $288.40 | $363.08 | $549.54 |
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 $302.00 Median $501.19 Typical High $812.83 | Professional | None | $302.00 | $501.19 | $812.83 |
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 $331.13 Median $524.81 Typical High $977.24 | Professional | None | $331.13 | $524.81 | $977.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $323.59 Median $398.11 Typical High $707.95 | Professional | None | $323.59 | $398.11 | $707.95 |
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 $316.23 Median $446.68 Typical High $794.33 | Professional | None | $316.23 | $446.68 | $794.33 |
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 $144.54 Median $144.54 Typical High $194.98 | Professional | 52 · Reduced service | $144.54 | $144.54 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $57.54 Typical High $79.43 | Professional | 53 · Discontinued | $57.54 | $57.54 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $213.80 Typical High $295.12 | Professional | 54 · Surgery only | $213.80 | $213.80 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $42.66 Typical High $58.88 | Professional | 55 · Aftercare only | $42.66 | $42.66 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $28.84 Typical High $38.90 | Professional | 56 · Pre-op care only | $28.84 | $28.84 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $199.53 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $199.53 | $199.53 | $275.42 |
Where Georgia sits
The same service costs 8.5 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· 26th of 51
$525
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.