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 $177.83 Median $3,548.13 Typical High $7,585.78 | Facility | None | $177.83 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $169.82 Typical High $190.55 | Professional | None | $144.54 | $169.82 | $190.55 |
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 $102.33 Median $213.80 Typical High $323.59 | Professional | None | $102.33 | $213.80 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $758.58 Typical High $1,000.00 | Facility | None | $398.11 | $758.58 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $263.03 Typical High $489.78 | Professional | None | $173.78 | $263.03 | $489.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $162.18 Median $208.93 Typical High $288.40 | Professional | None | $162.18 | $208.93 | $288.40 |
United Setting Facility Modifier None Typical Low $501.19 Median $724.44 Typical High $3,548.13 | Facility | None | $501.19 | $724.44 | $3,548.13 |
United Setting Professional Modifier None Typical Low $154.88 Median $229.09 Typical High $416.87 | Professional | None | $154.88 | $229.09 | $416.87 |
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 $72.44 Median $85.11 Typical High $89.13 | Professional | 52 · Reduced service | $72.44 | $85.11 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $33.88 Typical High $35.48 | Professional | 53 · Discontinued | $28.84 | $33.88 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $125.89 Typical High $134.90 | Professional | 54 · Surgery only | $109.65 | $125.89 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $25.70 Typical High $26.92 | Professional | 55 · Aftercare only | $21.88 | $25.70 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $16.98 Typical High $17.78 | Professional | 56 · Pre-op care only | $14.45 | $16.98 | $17.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $117.49 Typical High $125.89 | Professional | 78 · Unplanned return to OR | $102.33 | $117.49 | $125.89 |
Where Georgia sits
The same service costs 4.6 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· 29th of 51
$229
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.