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 $501.19 Median $3,548.13 Typical High $7,585.78 | Facility | None | $501.19 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $501.19 Typical High $1,174.90 | Professional | None | $281.84 | $501.19 | $1,174.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $380.19 Median $776.25 Typical High $3,630.78 | Facility | None | $380.19 | $776.25 | $3,630.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $245.47 Median $354.81 Typical High $691.83 | Professional | None | $245.47 | $354.81 | $691.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $398.11 Median $537.03 Typical High $1,023.29 | Professional | 50 · Both sides | $398.11 | $537.03 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $218.78 Typical High $616.60 | Facility | None | $154.88 | $218.78 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $537.03 Typical High $977.24 | Professional | None | $275.42 | $537.03 | $977.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $269.15 Median $524.81 Typical High $794.33 | Professional | None | $269.15 | $524.81 | $794.33 |
United Setting Facility Modifier None Typical Low $79.43 Median $158.49 Typical High $1,778.28 | Facility | None | $79.43 | $158.49 | $1,778.28 |
United Setting Professional Modifier None Typical Low $275.42 Median $501.19 Typical High $954.99 | Professional | None | $275.42 | $501.19 | $954.99 |
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 $141.25 Median $208.93 Typical High $275.42 | Professional | 52 · Reduced service | $141.25 | $208.93 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $83.18 Typical High $109.65 | Professional | 53 · Discontinued | $56.23 | $83.18 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $309.03 Typical High $416.87 | Professional | 54 · Surgery only | $213.80 | $309.03 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $61.66 Typical High $83.18 | Professional | 55 · Aftercare only | $42.66 | $61.66 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $41.69 Typical High $54.95 | Professional | 56 · Pre-op care only | $28.18 | $41.69 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $288.40 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $199.53 | $288.40 | $389.05 |
Where Georgia sits
The same service costs 3.4 times more in Alaska than in Maryland. 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· 36th of 51
$398
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.