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 $363.08 Median $5,370.32 Typical High $7,943.28 | Facility | None | $363.08 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $363.08 Typical High $398.11 | Professional | None | $223.87 | $363.08 | $398.11 |
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 $190.55 Median $288.40 Typical High $549.54 | Professional | None | $190.55 | $288.40 | $549.54 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $338.84 Median $457.09 Typical High $851.14 | Professional | 50 · Both sides | $338.84 | $457.09 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $323.59 Typical High $660.69 | Facility | None | $245.47 | $323.59 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $416.87 Typical High $707.95 | Professional | None | $257.04 | $416.87 | $707.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $218.78 Median $380.19 Typical High $616.60 | Professional | None | $218.78 | $380.19 | $616.60 |
Oscar Health Setting Professional Modifier None Typical Low $251.19 Median $389.05 Typical High $467.74 | Professional | None | $251.19 | $389.05 | $467.74 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,479.11 Typical High $5,011.87 | Facility | None | $851.14 | $1,479.11 | $5,011.87 |
United Setting Professional Modifier None Typical Low $218.78 Median $380.19 Typical High $676.08 | Professional | None | $218.78 | $380.19 | $676.08 |
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 $112.20 Median $151.36 Typical High $199.53 | Professional | 52 · Reduced service | $112.20 | $151.36 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $60.26 Typical High $79.43 | Professional | 53 · Discontinued | $44.67 | $60.26 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $223.87 Typical High $295.12 | Professional | 54 · Surgery only | $165.96 | $223.87 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $44.67 Typical High $58.88 | Professional | 55 · Aftercare only | $33.11 | $44.67 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $30.20 Typical High $39.81 | Professional | 56 · Pre-op care only | $22.39 | $30.20 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $208.93 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $154.88 | $208.93 | $275.42 |
Where Georgia sits
The same service costs 4.3 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· 31st of 51
$331
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.