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 $1,230.27 Median $5,011.87 Typical High $10,000.00 | Facility | None | $1,230.27 | $5,011.87 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,479.11 | Professional | None | $1,230.27 | $1,230.27 | $1,479.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $691.83 Median $1,348.96 Typical High $7,244.36 | Facility | None | $691.83 | $1,348.96 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,000.00 Median $1,659.59 Typical High $2,630.27 | Professional | None | $1,000.00 | $1,659.59 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $741.31 Median $1,071.52 Typical High $1,698.24 | Professional | 62 · Two surgeons | $741.31 | $1,071.52 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $288.40 Typical High $436.52 | Professional | 80 · Assistant surgeon | $186.21 | $288.40 | $436.52 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $245.47 Typical High $380.19 | Professional | AS · PA/NP assist | $165.96 | $245.47 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,388.44 Typical High $4,265.80 | Facility | None | $602.56 | $3,388.44 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,995.26 Typical High $3,019.95 | Professional | None | $1,380.38 | $1,995.26 | $3,019.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,148.15 Median $1,318.26 Typical High $5,623.41 | Professional | None | $1,148.15 | $1,318.26 | $5,623.41 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $2,884.03 Typical High $8,709.64 | Facility | None | $1,258.93 | $2,884.03 | $8,709.64 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,819.70 Typical High $2,951.21 | Professional | None | $1,096.48 | $1,819.70 | $2,951.21 |
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 $616.60 Median $616.60 Typical High $691.83 | Professional | 52 · Reduced service | $616.60 | $616.60 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $245.47 Typical High $275.42 | Professional | 53 · Discontinued | $245.47 | $245.47 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $933.25 Typical High $1,047.13 | Professional | 54 · Surgery only | $912.01 | $933.25 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $186.21 Typical High $208.93 | Professional | 55 · Aftercare only | $181.97 | $186.21 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $138.04 | Professional | 56 · Pre-op care only | $123.03 | $123.03 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $870.96 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $851.14 | $870.96 | $977.24 |
Where Georgia sits
The same service costs 16.6 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
$1,698
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.