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 $1,000.00 Median $7,079.46 Typical High $12,302.69 | Facility | None | $1,000.00 | $7,079.46 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,096.48 Typical High $2,951.21 | Professional | None | $1,000.00 | $1,096.48 | $2,951.21 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $2,089.30 Typical High $13,803.84 | Facility | None | $1,047.13 | $2,089.30 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,621.81 Typical High $2,454.71 | Professional | None | $977.24 | $1,621.81 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $9,772.37 Median $14,454.40 Typical High $34,673.69 | Facility | None | $9,772.37 | $14,454.40 | $34,673.69 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,862.09 Typical High $3,801.89 | Professional | None | $1,258.93 | $1,862.09 | $3,801.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,148.15 Median $1,258.93 Typical High $2,137.96 | Professional | None | $1,148.15 | $1,258.93 | $2,137.96 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $3,715.35 Typical High $9,120.11 | Facility | None | $1,513.56 | $3,715.35 | $9,120.11 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,698.24 Typical High $3,890.45 | Professional | None | $1,122.02 | $1,698.24 | $3,890.45 |
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 $501.19 Median $549.54 Typical High $630.96 | Professional | 52 · Reduced service | $501.19 | $549.54 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $218.78 Typical High $251.19 | Professional | 53 · Discontinued | $199.53 | $218.78 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $812.83 Typical High $933.25 | Professional | 54 · Surgery only | $741.31 | $812.83 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $162.18 Typical High $186.21 | Professional | 55 · Aftercare only | $147.91 | $162.18 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $109.65 Typical High $125.89 | Professional | 56 · Pre-op care only | $100.00 | $109.65 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $758.58 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $691.83 | $758.58 | $870.96 |
Where Georgia sits
The same service costs 8.9 times more in Oklahoma than in Texas. 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· 25th of 51
$1,738
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.