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 $177.83 Median $3,548.13 Typical High $7,585.78 | Facility | None | $177.83 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $181.97 Typical High $234.42 | Professional | None | $169.82 | $181.97 | $234.42 |
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 $131.83 Median $204.17 Typical High $389.05 | Professional | None | $131.83 | $204.17 | $389.05 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $218.78 Median $309.03 Typical High $575.44 | Professional | 50 · Both sides | $218.78 | $309.03 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $93.33 Median $125.89 Typical High $602.56 | Facility | None | $93.33 | $125.89 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $223.87 Typical High $389.05 | Professional | None | $158.49 | $223.87 | $389.05 |
Kaiser Permanente Setting Professional Modifier None Typical Low $162.18 Median $194.98 Typical High $398.11 | Professional | None | $162.18 | $194.98 | $398.11 |
Oscar Health Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
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 $144.54 Median $218.78 Typical High $398.11 | Professional | None | $144.54 | $218.78 | $398.11 |
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 $83.18 Median $89.13 Typical High $97.72 | Professional | 52 · Reduced service | $83.18 | $89.13 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $35.48 Typical High $39.81 | Professional | 53 · Discontinued | $33.88 | $35.48 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $134.90 Typical High $147.91 | Professional | 54 · Surgery only | $125.89 | $134.90 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $26.92 Typical High $29.51 | Professional | 55 · Aftercare only | $25.12 | $26.92 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $17.78 Typical High $19.95 | Professional | 56 · Pre-op care only | $16.98 | $17.78 | $19.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $125.89 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $117.49 | $125.89 | $138.04 |
Where Georgia sits
The same service costs 4.6 times more in Alaska than in Florida. 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· 21st of 51
$219
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.