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 $588.84 Median $5,370.32 Typical High $9,549.93 | Facility | None | $588.84 | $5,370.32 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $645.65 Typical High $1,412.54 | Professional | None | $562.34 | $645.65 | $1,412.54 |
Ambetter Setting Professional Modifier None Typical Low $741.31 Median $891.25 Typical High $1,000.00 | Professional | None | $741.31 | $891.25 | $1,000.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $380.19 Median $776.25 Typical High $3,630.78 | Facility | None | $380.19 | $776.25 | $3,630.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $489.78 Median $676.08 Typical High $1,000.00 | Professional | None | $489.78 | $676.08 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $776.25 Median $1,047.13 Typical High $1,479.11 | Professional | 50 · Both sides | $776.25 | $1,047.13 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $380.19 Typical High $691.83 | Facility | None | $295.12 | $380.19 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $851.14 Typical High $1,348.96 | Professional | None | $524.81 | $851.14 | $1,348.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $537.03 Median $630.96 Typical High $1,659.59 | Professional | None | $537.03 | $630.96 | $1,659.59 |
Oscar Health Setting Professional Modifier None Typical Low $630.96 Median $707.95 Typical High $812.83 | Professional | None | $630.96 | $707.95 | $812.83 |
United Setting Facility Modifier None Typical Low $331.13 Median $501.19 Typical High $2,454.71 | Facility | None | $331.13 | $501.19 | $2,454.71 |
United Setting Professional Modifier None Typical Low $512.86 Median $794.33 Typical High $1,348.96 | Professional | None | $512.86 | $794.33 | $1,348.96 |
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 $281.84 Median $288.40 Typical High $323.59 | Professional | 52 · Reduced service | $281.84 | $288.40 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $117.49 Typical High $128.82 | Professional | 53 · Discontinued | $112.20 | $117.49 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $436.52 Typical High $489.78 | Professional | 54 · Surgery only | $416.87 | $436.52 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $87.10 Typical High $97.72 | Professional | 55 · Aftercare only | $83.18 | $87.10 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $58.88 Typical High $64.57 | Professional | 56 · Pre-op care only | $56.23 | $58.88 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $407.38 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $389.05 | $407.38 | $457.09 |
Where Georgia sits
The same service costs 6.2 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· 25th of 51
$676
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.