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 $446.68 Median $4,466.84 Typical High $7,585.78 | Facility | None | $446.68 | $4,466.84 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $446.68 Typical High $1,047.13 | Professional | None | $398.11 | $446.68 | $1,047.13 |
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 $288.40 Median $467.74 Typical High $676.08 | Professional | None | $288.40 | $467.74 | $676.08 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $512.86 Median $724.44 Typical High $1,000.00 | Professional | 50 · Both sides | $512.86 | $724.44 | $1,000.00 |
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 $371.54 Median $537.03 Typical High $933.25 | Professional | None | $371.54 | $537.03 | $933.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $380.19 Median $478.63 Typical High $1,174.90 | Professional | None | $380.19 | $478.63 | $1,174.90 |
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 $346.74 Median $512.86 Typical High $954.99 | Professional | None | $346.74 | $512.86 | $954.99 |
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 $199.53 Median $223.87 Typical High $245.47 | Professional | 52 · Reduced service | $199.53 | $223.87 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $89.13 Typical High $97.72 | Professional | 53 · Discontinued | $79.43 | $89.13 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $331.13 Typical High $363.08 | Professional | 54 · Surgery only | $302.00 | $331.13 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $66.07 Typical High $74.13 | Professional | 55 · Aftercare only | $60.26 | $66.07 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $44.67 Typical High $48.98 | Professional | 56 · Pre-op care only | $39.81 | $44.67 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $309.03 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $281.84 | $309.03 | $338.84 |
Where Georgia sits
The same service costs 5.6 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· 23rd of 51
$479
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.