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 $977.24 Median $5,370.32 Typical High $7,943.28 | Facility | None | $977.24 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $851.14 Typical High $3,801.89 | Professional | None | $776.25 | $851.14 | $3,801.89 |
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 $776.25 Median $1,122.02 Typical High $1,862.09 | Professional | None | $776.25 | $1,122.02 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $512.86 Median $707.95 Typical High $1,230.27 | Professional | 62 · Two surgeons | $512.86 | $707.95 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $181.97 Typical High $323.59 | Professional | 80 · Assistant surgeon | $131.83 | $181.97 | $323.59 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $158.49 Typical High $269.15 | Professional | AS · PA/NP assist | $112.20 | $158.49 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,318.26 Typical High $1,819.70 | Facility | None | $602.56 | $1,318.26 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $1,659.59 Typical High $1,819.70 | Professional | None | $758.58 | $1,659.59 | $1,819.70 |
Kaiser Permanente Setting Professional Modifier None Typical Low $933.25 Median $1,047.13 Typical High $1,659.59 | Professional | None | $933.25 | $1,047.13 | $1,659.59 |
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 $831.76 Median $1,348.96 Typical High $2,398.83 | Professional | None | $831.76 | $1,348.96 | $2,398.83 |
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 $389.05 Median $407.38 Typical High $501.19 | Professional | 52 · Reduced service | $389.05 | $407.38 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $162.18 Typical High $199.53 | Professional | 53 · Discontinued | $158.49 | $162.18 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $616.60 Typical High $741.31 | Professional | 54 · Surgery only | $588.84 | $616.60 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $123.03 Typical High $147.91 | Professional | 55 · Aftercare only | $117.49 | $123.03 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $81.28 Typical High $100.00 | Professional | 56 · Pre-op care only | $77.62 | $81.28 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $575.44 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $549.54 | $575.44 | $691.83 |
Where Georgia sits
The same service costs 7.6 times more in Alaska 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· 23rd of 51
$1,122
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.