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 $870.96 Median $5,370.32 Typical High $8,317.64 | Facility | None | $870.96 | $5,370.32 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $758.58 Typical High $1,096.48 | Professional | None | $707.95 | $758.58 | $1,096.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $660.69 Median $1,202.26 Typical High $4,570.88 | Facility | None | $660.69 | $1,202.26 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $512.86 Median $851.14 Typical High $1,380.38 | Professional | None | $512.86 | $851.14 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $912.01 Median $1,288.25 Typical High $2,089.30 | Professional | 50 · Both sides | $912.01 | $1,288.25 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,258.93 Typical High $1,737.80 | Facility | None | $741.31 | $1,258.93 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $977.24 Typical High $1,621.81 | Professional | None | $676.08 | $977.24 | $1,621.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $630.96 Median $707.95 Typical High $1,096.48 | Professional | None | $630.96 | $707.95 | $1,096.48 |
Oscar Health Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $891.25 | Professional | None | $794.33 | $794.33 | $891.25 |
United Setting Facility Modifier None Typical Low $331.13 Median $501.19 Typical High $2,454.71 | Facility | None | $331.13 | $501.19 | $2,454.71 |
United Setting Professional Modifier None Typical Low $562.34 Median $851.14 Typical High $1,698.24 | Professional | None | $562.34 | $851.14 | $1,698.24 |
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 $354.81 Median $363.08 Typical High $398.11 | Professional | 52 · Reduced service | $354.81 | $363.08 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $144.54 Typical High $158.49 | Professional | 53 · Discontinued | $141.25 | $144.54 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $549.54 Typical High $602.56 | Professional | 54 · Surgery only | $524.81 | $549.54 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $109.65 Typical High $120.23 | Professional | 55 · Aftercare only | $104.71 | $109.65 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $72.44 Typical High $79.43 | Professional | 56 · Pre-op care only | $70.79 | $72.44 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $512.86 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $489.78 | $512.86 | $562.34 |
Where Georgia sits
The same service costs 7.6 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· 24th of 51
$851
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.