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 $204.17 Median $3,548.13 Typical High $7,585.78 | Facility | None | $204.17 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $204.17 Typical High $467.74 | Professional | None | $125.89 | $204.17 | $467.74 |
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 $91.20 Median $151.36 Typical High $213.80 | Professional | None | $91.20 | $151.36 | $213.80 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $162.18 Median $229.09 Typical High $316.23 | Professional | 50 · Both sides | $162.18 | $229.09 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $1,445.44 Typical High $1,819.70 | Facility | None | $398.11 | $1,445.44 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $204.17 Typical High $398.11 | Professional | None | $114.82 | $204.17 | $398.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $120.23 Median $213.80 Typical High $316.23 | Professional | None | $120.23 | $213.80 | $316.23 |
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 $112.20 Median $199.53 Typical High $380.19 | Professional | None | $112.20 | $199.53 | $380.19 |
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 $61.66 Median $83.18 Typical High $109.65 | Professional | 52 · Reduced service | $61.66 | $83.18 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $33.11 Typical High $43.65 | Professional | 53 · Discontinued | $25.12 | $33.11 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $125.89 Typical High $165.96 | Professional | 54 · Surgery only | $93.33 | $125.89 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $25.12 Typical High $33.11 | Professional | 55 · Aftercare only | $18.62 | $25.12 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $16.60 Typical High $21.88 | Professional | 56 · Pre-op care only | $12.59 | $16.60 | $21.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $117.49 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $87.10 | $117.49 | $154.88 |
Where Georgia sits
The same service costs 4.8 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· 33rd of 51
$178
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.