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 $275.42 Median $3,548.13 Typical High $7,585.78 | Facility | None | $275.42 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $257.04 Typical High $346.74 | Professional | None | $109.65 | $257.04 | $346.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $512.86 Median $1,000.00 Typical High $4,570.88 | Facility | None | $512.86 | $1,000.00 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $89.13 Median $134.90 Typical High $275.42 | Professional | None | $89.13 | $134.90 | $275.42 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $147.91 Median $204.17 Typical High $426.58 | Professional | 50 · Both sides | $147.91 | $204.17 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $269.15 Typical High $645.65 | Facility | None | $204.17 | $269.15 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $239.88 Typical High $549.54 | Professional | None | $104.71 | $239.88 | $549.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $107.15 Median $281.84 Typical High $398.11 | Professional | None | $107.15 | $281.84 | $398.11 |
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 $100.00 Median $239.88 Typical High $512.86 | Professional | None | $100.00 | $239.88 | $512.86 |
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 $54.95 Median $100.00 Typical High $154.88 | Professional | 52 · Reduced service | $54.95 | $100.00 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $39.81 Typical High $61.66 | Professional | 53 · Discontinued | $21.88 | $39.81 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $147.91 Typical High $229.09 | Professional | 54 · Surgery only | $83.18 | $147.91 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $29.51 Typical High $45.71 | Professional | 55 · Aftercare only | $16.60 | $29.51 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $19.95 Typical High $30.90 | Professional | 56 · Pre-op care only | $10.96 | $19.95 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $138.04 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $77.62 | $138.04 | $213.80 |
Where Georgia sits
The same service costs 5.6 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· 45th 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.