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 $562.34 Median $5,495.41 Typical High $9,549.93 | Facility | None | $562.34 | $5,495.41 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $616.60 Typical High $1,862.09 | Professional | None | $562.34 | $616.60 | $1,862.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $1,412.54 Typical High $5,754.40 | Facility | None | $741.31 | $1,412.54 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $436.52 Median $691.83 Typical High $1,000.00 | Professional | None | $436.52 | $691.83 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $758.58 Median $1,023.29 Typical High $1,479.11 | Professional | 50 · Both sides | $758.58 | $1,023.29 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $1,995.26 Typical High $2,754.23 | Facility | None | $812.83 | $1,995.26 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $812.83 Typical High $1,318.26 | Professional | None | $512.86 | $812.83 | $1,318.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $501.19 Median $562.34 Typical High $1,621.81 | Professional | None | $501.19 | $562.34 | $1,621.81 |
Oscar Health Setting Professional Modifier None Typical Low $630.96 Median $724.44 Typical High $758.58 | Professional | None | $630.96 | $724.44 | $758.58 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $7,585.78 | Facility | None | $954.99 | $1,995.26 | $7,585.78 |
United Setting Professional Modifier None Typical Low $467.74 Median $707.95 Typical High $1,348.96 | Professional | None | $467.74 | $707.95 | $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 $295.12 Typical High $323.59 | Professional | 52 · Reduced service | $281.84 | $295.12 | $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 $426.58 Median $436.52 Typical High $478.63 | Professional | 54 · Surgery only | $426.58 | $436.52 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $87.10 Typical High $95.50 | Professional | 55 · Aftercare only | $85.11 | $87.10 | $95.50 |
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 $398.11 Median $407.38 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $398.11 | $407.38 | $446.68 |
Where Georgia sits
The same service costs 7.9 times more in Wyoming 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
$776
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.