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 $87.10 Median $5,370.32 Typical High $7,585.78 | Facility | None | $87.10 | $5,370.32 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $107.15 Typical High $245.47 | Professional | None | $87.10 | $107.15 | $245.47 |
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 $72.44 Median $109.65 Typical High $165.96 | Professional | None | $72.44 | $109.65 | $165.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $120.23 Median $162.18 Typical High $251.19 | Professional | 50 · Both sides | $120.23 | $162.18 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $346.74 Typical High $4,265.80 | Facility | None | $50.12 | $346.74 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $144.54 Typical High $218.78 | Professional | None | $97.72 | $144.54 | $218.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $87.10 Median $114.82 Typical High $208.93 | Professional | None | $87.10 | $114.82 | $208.93 |
Oscar Health Setting Professional Modifier None Typical Low $100.00 Median $114.82 Typical High $138.04 | Professional | None | $100.00 | $114.82 | $138.04 |
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 $85.11 Median $134.90 Typical High $223.87 | Professional | None | $85.11 | $134.90 | $223.87 |
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 $43.65 Median $48.98 Typical High $60.26 | Professional | 52 · Reduced service | $43.65 | $48.98 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $19.50 Typical High $23.99 | Professional | 53 · Discontinued | $17.78 | $19.50 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $74.13 Typical High $89.13 | Professional | 54 · Surgery only | $66.07 | $74.13 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $14.79 Typical High $17.78 | Professional | 55 · Aftercare only | $13.18 | $14.79 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $9.77 Typical High $12.02 | Professional | 56 · Pre-op care only | $8.71 | $9.77 | $12.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $61.66 Median $69.18 Typical High $83.18 | Professional | 78 · Unplanned return to OR | $61.66 | $69.18 | $83.18 |
Where Georgia sits
The same service costs 4.2 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· 28th of 51
$120
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.