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 $977.24 Median $5,011.87 Typical High $7,943.28 | Facility | None | $977.24 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,023.29 Typical High $1,479.11 | Professional | None | $954.99 | $1,023.29 | $1,479.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $512.86 Median $1,071.52 Typical High $5,754.40 | Facility | None | $512.86 | $1,071.52 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $707.95 Median $1,122.02 Typical High $1,621.81 | Professional | None | $707.95 | $1,122.02 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,122.02 Median $1,698.24 Typical High $2,454.71 | Professional | 50 · Both sides | $1,122.02 | $1,698.24 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,995.26 Typical High $2,511.89 | Facility | None | $524.81 | $1,995.26 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,174.90 Typical High $2,290.87 | Professional | None | $794.33 | $1,174.90 | $2,290.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $891.25 Median $1,023.29 Typical High $1,412.54 | Professional | None | $891.25 | $1,023.29 | $1,412.54 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $7,585.78 | Facility | None | $954.99 | $1,995.26 | $7,585.78 |
United Setting Professional Modifier None Typical Low $741.31 Median $1,096.48 Typical High $2,344.23 | Professional | None | $741.31 | $1,096.48 | $2,344.23 |
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 $478.63 Median $489.78 Typical High $537.03 | Professional | 52 · Reduced service | $478.63 | $489.78 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $194.98 Typical High $213.80 | Professional | 53 · Discontinued | $190.55 | $194.98 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $794.33 | Professional | 54 · Surgery only | $724.44 | $724.44 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $147.91 Typical High $162.18 | Professional | 55 · Aftercare only | $144.54 | $147.91 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $97.72 Typical High $107.15 | Professional | 56 · Pre-op care only | $95.50 | $97.72 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $676.08 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $676.08 | $676.08 | $758.58 |
Where Georgia sits
The same service costs 8.3 times more in Wyoming 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· 22nd of 51
$1,148
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.