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 $1,202.26 Median $5,370.32 Typical High $8,317.64 | Facility | None | $1,202.26 | $5,370.32 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $1,862.09 Typical High $2,951.21 | Professional | None | $501.19 | $1,862.09 | $2,951.21 |
Ambetter Setting Professional Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $3,715.35 | Professional | None | $3,715.35 | $3,715.35 | $3,715.35 |
Anthem BCBS Setting Facility Modifier None Typical Low $691.83 Median $1,348.96 Typical High $7,244.36 | Facility | None | $691.83 | $1,348.96 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $407.38 Median $602.56 Typical High $1,288.25 | Professional | None | $407.38 | $602.56 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $676.08 Median $912.01 Typical High $1,621.81 | Professional | 50 · Both sides | $676.08 | $912.01 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,073.80 Typical High $5,128.61 | Facility | None | $602.56 | $4,073.80 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $2,041.74 Typical High $4,786.30 | Professional | None | $380.19 | $2,041.74 | $4,786.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $478.63 Median $2,454.71 Typical High $5,888.44 | Professional | None | $478.63 | $2,454.71 | $5,888.44 |
Oscar Health Setting Professional Modifier None Typical Low $562.34 Median $2,570.40 Typical High $3,090.30 | Professional | None | $562.34 | $2,570.40 | $3,090.30 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $2,884.03 Typical High $8,709.64 | Facility | None | $1,258.93 | $2,884.03 | $8,709.64 |
United Setting Professional Modifier None Typical Low $457.09 Median $2,187.76 Typical High $5,011.87 | Professional | None | $457.09 | $2,187.76 | $5,011.87 |
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 $251.19 Median $389.05 Typical High $1,445.44 | Professional | 52 · Reduced service | $251.19 | $389.05 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $154.88 Typical High $575.44 | Professional | 53 · Discontinued | $100.00 | $154.88 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $588.84 Typical High $2,187.76 | Professional | 54 · Surgery only | $371.54 | $588.84 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $117.49 Typical High $436.52 | Professional | 55 · Aftercare only | $74.13 | $117.49 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $77.62 Typical High $288.40 | Professional | 56 · Pre-op care only | $50.12 | $77.62 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $549.54 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $346.74 | $549.54 | $2,041.74 |
Where Georgia sits
The same service costs 9.8 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· 47th of 51
$724
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.