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 $602.56 Median $5,370.32 Typical High $7,762.47 | Facility | None | $602.56 | $5,370.32 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $602.56 Typical High $707.95 | Professional | None | $426.58 | $602.56 | $707.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $562.34 Median $1,071.52 Typical High $4,570.88 | Facility | None | $562.34 | $1,071.52 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $489.78 Median $776.25 Typical High $1,230.27 | Professional | None | $489.78 | $776.25 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $812.83 Median $1,230.27 Typical High $1,905.46 | Professional | 50 · Both sides | $812.83 | $1,230.27 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,698.24 Typical High $2,290.87 | Facility | None | $602.56 | $1,698.24 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $831.76 Typical High $1,584.89 | Professional | None | $524.81 | $831.76 | $1,584.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $436.52 Median $660.69 Typical High $1,122.02 | Professional | None | $436.52 | $660.69 | $1,122.02 |
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 $478.63 Median $776.25 Typical High $1,479.11 | Professional | None | $478.63 | $776.25 | $1,479.11 |
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 $213.80 Median $302.00 Typical High $338.84 | Professional | 52 · Reduced service | $213.80 | $302.00 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $120.23 Typical High $134.90 | Professional | 53 · Discontinued | $85.11 | $120.23 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $446.68 Typical High $501.19 | Professional | 54 · Surgery only | $323.59 | $446.68 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $89.13 Typical High $102.33 | Professional | 55 · Aftercare only | $64.57 | $89.13 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $60.26 Typical High $67.61 | Professional | 56 · Pre-op care only | $42.66 | $60.26 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $416.87 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $302.00 | $416.87 | $467.74 |
Where Georgia sits
The same service costs 4.1 times more in Alaska than in Kentucky. 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
$813
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.