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 $2,089.30 Median $5,370.32 Typical High $7,943.28 | Facility | None | $2,089.30 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,398.83 | Professional | None | $2,089.30 | $2,089.30 | $2,398.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,071.52 Median $1,905.46 Typical High $11,220.18 | Facility | None | $1,071.52 | $1,905.46 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,041.74 Median $2,951.21 Typical High $5,128.61 | Professional | None | $2,041.74 | $2,951.21 | $5,128.61 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,318.26 Median $1,995.26 Typical High $3,311.31 | Professional | 62 · Two surgeons | $1,318.26 | $1,995.26 | $3,311.31 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $338.84 Median $562.34 Typical High $851.14 | Professional | 80 · Assistant surgeon | $338.84 | $562.34 | $851.14 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $302.00 Median $436.52 Typical High $741.31 | Professional | AS · PA/NP assist | $302.00 | $436.52 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,348.96 Typical High $2,511.89 | Facility | None | $630.96 | $1,348.96 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $2,398.83 Median $3,467.37 Typical High $5,370.32 | Professional | None | $2,398.83 | $3,467.37 | $5,370.32 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,089.30 Median $2,344.23 Typical High $5,128.61 | Professional | None | $2,089.30 | $2,344.23 | $5,128.61 |
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 $2,041.74 Median $3,467.37 Typical High $5,495.41 | Professional | None | $2,041.74 | $3,467.37 | $5,495.41 |
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 $1,047.13 Median $1,047.13 Typical High $1,174.90 | Professional | 52 · Reduced service | $1,047.13 | $1,047.13 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $426.58 Typical High $478.63 | Professional | 53 · Discontinued | $426.58 | $426.58 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,584.89 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,584.89 | $1,584.89 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $316.23 Typical High $354.81 | Professional | 55 · Aftercare only | $316.23 | $316.23 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $208.93 Typical High $239.88 | Professional | 56 · Pre-op care only | $208.93 | $208.93 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,479.11 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,479.11 | $1,659.59 |
Where Georgia sits
The same service costs 19.5 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· 22nd of 51
$2,884
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.