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 $263.03 Median $4,466.84 Typical High $7,585.78 | Facility | None | $263.03 | $4,466.84 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $257.04 Typical High $302.00 | Professional | None | $194.98 | $257.04 | $302.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $467.74 Median $851.14 Typical High $3,630.78 | Facility | None | $467.74 | $851.14 | $3,630.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $173.78 Median $263.03 Typical High $489.78 | Professional | None | $173.78 | $263.03 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $588.84 Typical High $891.25 | Facility | None | $457.09 | $588.84 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $331.13 Typical High $645.65 | Professional | None | $218.78 | $331.13 | $645.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $234.42 Median $338.84 Typical High $489.78 | Professional | None | $234.42 | $338.84 | $489.78 |
Oscar Health Setting Professional Modifier None Typical Low $281.84 Median $371.54 Typical High $467.74 | Professional | None | $281.84 | $371.54 | $467.74 |
United Setting Facility Modifier None Typical Low $331.13 Median $489.78 Typical High $2,454.71 | Facility | None | $331.13 | $489.78 | $2,454.71 |
United Setting Professional Modifier None Typical Low $190.55 Median $323.59 Typical High $588.84 | Professional | None | $190.55 | $323.59 | $588.84 |
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 $97.72 Median $123.03 Typical High $141.25 | Professional | 52 · Reduced service | $97.72 | $123.03 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $48.98 Typical High $56.23 | Professional | 53 · Discontinued | $38.90 | $48.98 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $181.97 Typical High $208.93 | Professional | 54 · Surgery only | $147.91 | $181.97 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $36.31 Typical High $42.66 | Professional | 55 · Aftercare only | $29.51 | $36.31 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $24.55 Typical High $28.18 | Professional | 56 · Pre-op care only | $19.50 | $24.55 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $169.82 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $138.04 | $169.82 | $194.98 |
Where Georgia sits
The same service costs 4.3 times more in Alaska than in Kentucky. 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· 24th of 51
$295
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.