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 $199.53 Median $4,897.79 Typical High $7,943.28 | Facility | None | $199.53 | $4,897.79 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $199.53 Typical High $275.42 | Professional | None | $120.23 | $199.53 | $275.42 |
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 $123.03 Median $239.88 Typical High $371.54 | Professional | None | $123.03 | $239.88 | $371.54 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $229.09 Median $354.81 Typical High $549.54 | Professional | 50 · Both sides | $229.09 | $354.81 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $218.78 Typical High $1,513.56 | Facility | None | $165.96 | $218.78 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $234.42 Typical High $512.86 | Professional | None | $134.90 | $234.42 | $512.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $123.03 Median $213.80 Typical High $275.42 | Professional | None | $123.03 | $213.80 | $275.42 |
United Setting Facility Modifier None Typical Low $501.19 Median $724.44 Typical High $3,548.13 | Facility | None | $501.19 | $724.44 | $3,548.13 |
United Setting Professional Modifier None Typical Low $128.82 Median $245.47 Typical High $467.74 | Professional | None | $128.82 | $245.47 | $467.74 |
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 $60.26 Median $100.00 Typical High $109.65 | Professional | 52 · Reduced service | $60.26 | $100.00 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $39.81 Typical High $43.65 | Professional | 53 · Discontinued | $23.99 | $39.81 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $147.91 Typical High $165.96 | Professional | 54 · Surgery only | $89.13 | $147.91 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $30.20 Typical High $33.11 | Professional | 55 · Aftercare only | $17.78 | $30.20 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $19.95 Typical High $21.88 | Professional | 56 · Pre-op care only | $12.02 | $19.95 | $21.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $138.04 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $83.18 | $138.04 | $154.88 |
Where Georgia sits
The same service costs 3.9 times more in Oklahoma 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· 20th of 51
$251
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.