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 $1,174.90 Median $5,623.41 Typical High $10,000.00 | Facility | None | $1,174.90 | $5,623.41 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,202.26 | Professional | None | $1,174.90 | $1,174.90 | $1,202.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,096.48 Median $2,511.89 Typical High $11,220.18 | Facility | None | $1,096.48 | $2,511.89 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,174.90 Median $1,380.38 Typical High $2,344.23 | Professional | None | $1,174.90 | $1,380.38 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $218.78 Typical High $380.19 | Professional | 80 · Assistant surgeon | $190.55 | $218.78 | $380.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $190.55 Typical High $331.13 | Professional | AS · PA/NP assist | $165.96 | $190.55 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $5,248.07 Typical High $6,760.83 | Facility | None | $602.56 | $5,248.07 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $5,754.40 | Professional | None | $1,862.09 | $1,862.09 | $5,754.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,288.25 Median $1,479.11 Typical High $2,041.74 | Professional | None | $1,288.25 | $1,479.11 | $2,041.74 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $3,715.35 Typical High $9,549.93 | Facility | None | $1,513.56 | $3,715.35 | $9,549.93 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $1,995.26 Typical High $3,162.28 | Professional | None | $1,148.15 | $1,995.26 | $3,162.28 |
5 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 $588.84 Median $588.84 Typical High $588.84 | Professional | 52 · Reduced service | $588.84 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $234.42 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $870.96 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $173.78 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $117.49 |
Where Georgia sits
The same service costs 5.9 times more in Texas 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· 25th of 51
$1,862
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.