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 $380.19 Median $4,168.69 Typical High $7,585.78 | Facility | None | $380.19 | $4,168.69 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $416.87 Typical High $891.25 | Professional | None | $354.81 | $416.87 | $891.25 |
Ambetter Setting Professional Modifier None Typical Low $263.03 Median $501.19 Typical High $645.65 | Professional | None | $263.03 | $501.19 | $645.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $478.63 Median $851.14 Typical High $3,630.78 | Facility | None | $478.63 | $851.14 | $3,630.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $251.19 Median $407.38 Typical High $588.84 | Professional | None | $251.19 | $407.38 | $588.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $436.52 Median $616.60 Typical High $891.25 | Professional | 50 · Both sides | $436.52 | $616.60 | $891.25 |
CareSource Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $398.11 Typical High $851.14 | Facility | None | $302.00 | $398.11 | $851.14 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $457.09 Typical High $812.83 | Professional | None | $331.13 | $457.09 | $812.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $338.84 Median $407.38 Typical High $724.44 | Professional | None | $338.84 | $407.38 | $724.44 |
Oscar Health Setting Facility Modifier None Typical Low $794.33 Median $794.33 Typical High $870.96 | Facility | None | $794.33 | $794.33 | $870.96 |
Oscar Health Setting Professional Modifier None Typical Low $389.05 Median $446.68 Typical High $524.81 | Professional | None | $389.05 | $446.68 | $524.81 |
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 $302.00 Median $457.09 Typical High $831.76 | Professional | None | $302.00 | $457.09 | $831.76 |
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 $173.78 Median $190.55 Typical High $208.93 | Professional | 52 · Reduced service | $173.78 | $190.55 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $75.86 Typical High $83.18 | Professional | 53 · Discontinued | $70.79 | $75.86 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $269.15 Typical High $309.03 | Professional | 54 · Surgery only | $245.47 | $269.15 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $56.23 Typical High $63.10 | Professional | 55 · Aftercare only | $52.48 | $56.23 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $38.02 Typical High $41.69 | Professional | 56 · Pre-op care only | $35.48 | $38.02 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $263.03 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $245.47 | $263.03 | $288.40 |
Where Georgia sits
The same service costs 5.8 times more in Alaska 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· 21st of 51
$427
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.