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 $426.58 Median $4,897.79 Typical High $7,943.28 | Facility | None | $426.58 | $4,897.79 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $426.58 Typical High $478.63 | Professional | None | $263.03 | $426.58 | $478.63 |
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 $223.87 Median $323.59 Typical High $630.96 | Professional | None | $223.87 | $323.59 | $630.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $363.08 Median $478.63 Typical High $954.99 | Professional | 50 · Both sides | $363.08 | $478.63 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $331.13 Typical High $1,288.25 | Facility | None | $245.47 | $331.13 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $457.09 Typical High $851.14 | Professional | None | $257.04 | $457.09 | $851.14 |
Kaiser Permanente Setting Professional Modifier None Typical Low $251.19 Median $457.09 Typical High $676.08 | Professional | None | $251.19 | $457.09 | $676.08 |
Oscar Health Setting Professional Modifier None Typical Low $295.12 Median $467.74 Typical High $549.54 | Professional | None | $295.12 | $467.74 | $549.54 |
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 $251.19 Median $446.68 Typical High $812.83 | Professional | None | $251.19 | $446.68 | $812.83 |
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 $131.83 Median $177.83 Typical High $234.42 | Professional | 52 · Reduced service | $131.83 | $177.83 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $70.79 Typical High $93.33 | Professional | 53 · Discontinued | $53.70 | $70.79 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $263.03 Typical High $354.81 | Professional | 54 · Surgery only | $199.53 | $263.03 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $52.48 Typical High $70.79 | Professional | 55 · Aftercare only | $39.81 | $52.48 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $35.48 Typical High $46.77 | Professional | 56 · Pre-op care only | $26.30 | $35.48 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $245.47 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $186.21 | $245.47 | $331.13 |
Where Georgia sits
The same service costs 3.9 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· 34th of 51
$372
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.