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 $5,370.32 Typical High $7,762.47 | Facility | None | $562.34 | $5,370.32 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $537.03 Typical High $616.60 | Professional | None | $346.74 | $537.03 | $616.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $562.34 Median $1,071.52 Typical High $4,570.88 | Facility | None | $562.34 | $1,071.52 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $275.42 Median $426.58 Typical High $776.25 | Professional | None | $275.42 | $426.58 | $776.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $457.09 Median $645.65 Typical High $1,148.15 | Professional | 50 · Both sides | $457.09 | $645.65 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,258.93 Typical High $1,737.80 | Facility | None | $602.56 | $1,258.93 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $512.86 Typical High $1,071.52 | Professional | None | $288.40 | $512.86 | $1,071.52 |
Kaiser Permanente Setting Professional Modifier None Typical Low $338.84 Median $575.44 Typical High $794.33 | Professional | None | $338.84 | $575.44 | $794.33 |
Oscar Health Setting Professional Modifier None Typical Low $398.11 Median $588.84 Typical High $707.95 | Professional | None | $398.11 | $588.84 | $707.95 |
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 $316.23 Median $524.81 Typical High $1,023.29 | Professional | None | $316.23 | $524.81 | $1,023.29 |
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 $173.78 Median $229.09 Typical High $302.00 | Professional | 52 · Reduced service | $173.78 | $229.09 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $91.20 Typical High $120.23 | Professional | 53 · Discontinued | $69.18 | $91.20 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $338.84 Typical High $446.68 | Professional | 54 · Surgery only | $263.03 | $338.84 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $67.61 Typical High $91.20 | Professional | 55 · Aftercare only | $52.48 | $67.61 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $45.71 Typical High $60.26 | Professional | 56 · Pre-op care only | $34.67 | $45.71 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $316.23 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $245.47 | $316.23 | $416.87 |
Where Georgia sits
The same service costs 5.9 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· 30th 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.