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 $125.89 Median $3,630.78 Typical High $7,943.28 | Facility | None | $125.89 | $3,630.78 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $117.49 Typical High $204.17 | Professional | None | $114.82 | $117.49 | $204.17 |
Anthem BCBS Setting Facility Modifier None Typical Low $380.19 Median $776.25 Typical High $3,630.78 | Facility | None | $380.19 | $776.25 | $3,630.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $97.72 Median $162.18 Typical High $275.42 | Professional | None | $97.72 | $162.18 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $467.74 Typical High $660.69 | Facility | None | $363.08 | $467.74 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $186.21 Typical High $363.08 | Professional | None | $128.82 | $186.21 | $363.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $117.49 Median $144.54 Typical High $257.04 | Professional | None | $117.49 | $144.54 | $257.04 |
United Setting Facility Modifier None Typical Low $331.13 Median $501.19 Typical High $2,454.71 | Facility | None | $331.13 | $501.19 | $2,454.71 |
United Setting Professional Modifier None Typical Low $112.20 Median $162.18 Typical High $354.81 | Professional | None | $112.20 | $162.18 | $354.81 |
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 $57.54 Median $57.54 Typical High $67.61 | Professional | 52 · Reduced service | $57.54 | $57.54 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $22.91 Typical High $26.92 | Professional | 53 · Discontinued | $22.91 | $22.91 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $87.10 Typical High $100.00 | Professional | 54 · Surgery only | $87.10 | $87.10 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $17.38 Typical High $19.95 | Professional | 55 · Aftercare only | $17.38 | $17.38 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $11.48 Typical High $13.49 | Professional | 56 · Pre-op care only | $11.48 | $11.48 | $13.49 |
Ambetter Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $616.60 |
Where Georgia sits
The same service costs 4.4 times more in Alaska than in New York. 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· 27th of 51
$186
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.