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 $2,691.53 Median $5,623.41 Typical High $10,000.00 | Facility | None | $2,691.53 | $5,623.41 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $3,019.95 | Professional | None | $2,691.53 | $2,691.53 | $3,019.95 |
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 $2,344.23 Median $3,630.78 Typical High $5,888.44 | Professional | None | $2,344.23 | $3,630.78 | $5,888.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,698.24 Median $2,398.83 Typical High $3,981.07 | Professional | 62 · Two surgeons | $1,698.24 | $2,398.83 | $3,981.07 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $416.87 Median $645.65 Typical High $1,000.00 | Professional | 80 · Assistant surgeon | $416.87 | $645.65 | $1,000.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $371.54 Median $537.03 Typical High $870.96 | Professional | AS · PA/NP assist | $371.54 | $537.03 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $5,623.41 Typical High $7,413.10 | Facility | None | $630.96 | $5,623.41 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $3,019.95 Median $4,365.16 Typical High $6,918.31 | Professional | None | $3,019.95 | $4,365.16 | $6,918.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,691.53 Median $3,019.95 Typical High $5,754.40 | Professional | None | $2,691.53 | $3,019.95 | $5,754.40 |
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 $2,398.83 Median $3,981.07 Typical High $6,760.83 | Professional | None | $2,398.83 | $3,981.07 | $6,760.83 |
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 $1,348.96 Median $1,348.96 Typical High $1,513.56 | Professional | 52 · Reduced service | $1,348.96 | $1,348.96 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $537.03 Median $537.03 Typical High $616.60 | Professional | 53 · Discontinued | $537.03 | $537.03 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,041.74 Median $2,041.74 Typical High $2,290.87 | Professional | 54 · Surgery only | $2,041.74 | $2,041.74 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $407.38 Median $407.38 Typical High $457.09 | Professional | 55 · Aftercare only | $407.38 | $407.38 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $269.15 Median $269.15 Typical High $302.00 | Professional | 56 · Pre-op care only | $269.15 | $269.15 | $302.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,905.46 Median $1,905.46 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $1,905.46 | $1,905.46 | $2,137.96 |
Where Georgia sits
The same service costs 8.7 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· 21st of 51
$3,631
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.