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 $338.84 Median $5,370.32 Typical High $8,128.31 | Facility | None | $338.84 | $5,370.32 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $380.19 Typical High $1,023.29 | Professional | None | $331.13 | $380.19 | $1,023.29 |
Ambetter Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | None | $933.25 | $933.25 | $933.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $1,288.25 Typical High $4,570.88 | Facility | None | $724.44 | $1,288.25 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $338.84 Median $524.81 Typical High $912.01 | Professional | None | $338.84 | $524.81 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $1,995.26 Typical High $2,754.23 | Facility | None | $812.83 | $1,995.26 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $537.03 Typical High $1,000.00 | Professional | None | $363.08 | $537.03 | $1,000.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $389.05 Median $501.19 Typical High $851.14 | Professional | None | $389.05 | $501.19 | $851.14 |
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 $389.05 Median $549.54 Typical High $954.99 | Professional | None | $389.05 | $549.54 | $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 $165.96 Median $181.97 Typical High $208.93 | Professional | 52 · Reduced service | $165.96 | $181.97 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $74.13 Typical High $83.18 | Professional | 53 · Discontinued | $67.61 | $74.13 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $275.42 Typical High $309.03 | Professional | 54 · Surgery only | $251.19 | $275.42 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $54.95 Typical High $61.66 | Professional | 55 · Aftercare only | $50.12 | $54.95 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $37.15 Typical High $41.69 | Professional | 56 · Pre-op care only | $33.11 | $37.15 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $257.04 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $234.42 | $257.04 | $288.40 |
Where Georgia sits
The same service costs 3.8 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· 23rd of 51
$550
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.