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 $1,202.26 Median $7,079.46 Typical High $12,302.69 | Facility | None | $1,202.26 | $7,079.46 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,258.93 Typical High $2,454.71 | Professional | None | $1,202.26 | $1,258.93 | $2,454.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $1,698.24 Typical High $7,244.36 | Facility | None | $954.99 | $1,698.24 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,778.28 Typical High $2,754.23 | Professional | None | $1,122.02 | $1,778.28 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,905.46 Median $2,691.53 Typical High $4,168.69 | Professional | 50 · Both sides | $1,905.46 | $2,691.53 | $4,168.69 |
Cigna Setting Facility Modifier None Typical Low $1,122.02 Median $3,467.37 Typical High $4,677.35 | Facility | None | $1,122.02 | $3,467.37 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $1,949.84 Typical High $3,388.44 | Professional | None | $1,348.96 | $1,949.84 | $3,388.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,202.26 Median $1,445.44 Typical High $3,162.28 | Professional | None | $1,202.26 | $1,445.44 | $3,162.28 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $2,884.03 Typical High $8,709.64 | Facility | None | $1,258.93 | $2,884.03 | $8,709.64 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,862.09 Typical High $3,162.28 | Professional | None | $1,258.93 | $1,862.09 | $3,162.28 |
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 $602.56 Median $602.56 Typical High $707.95 | Professional | 52 · Reduced service | $602.56 | $602.56 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $245.47 Typical High $281.84 | Professional | 53 · Discontinued | $245.47 | $245.47 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $912.01 Typical High $1,071.52 | Professional | 54 · Surgery only | $912.01 | $912.01 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $181.97 Typical High $213.80 | Professional | 55 · Aftercare only | $181.97 | $181.97 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $120.23 Typical High $141.25 | Professional | 56 · Pre-op care only | $120.23 | $120.23 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $851.14 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $851.14 | $851.14 | $1,000.00 |
Where Georgia sits
The same service costs 6.2 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· 28th of 51
$1,778
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.