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 $562.34 Median $5,370.32 Typical High $11,481.54 | Facility | None | $562.34 | $5,370.32 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $660.69 Typical High $776.25 | Professional | None | $562.34 | $660.69 | $776.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $794.33 Median $1,621.81 Typical High $4,677.35 | Facility | None | $794.33 | $1,621.81 | $4,677.35 |
Anthem BCBS Setting Professional Modifier None Typical Low $467.74 Median $758.58 Typical High $1,258.93 | Professional | None | $467.74 | $758.58 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $154.88 Typical High $208.93 | Professional | 80 · Assistant surgeon | $93.33 | $154.88 | $208.93 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $83.18 Median $125.89 Typical High $177.83 | Professional | AS · PA/NP assist | $83.18 | $125.89 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $1,122.02 Median $2,511.89 Typical High $3,467.37 | Facility | None | $1,122.02 | $2,511.89 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $1,023.29 Typical High $1,412.54 | Professional | None | $707.95 | $1,023.29 | $1,412.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $575.44 Median $794.33 Typical High $1,905.46 | Professional | None | $575.44 | $794.33 | $1,905.46 |
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 $588.84 Median $977.24 Typical High $1,513.56 | Professional | None | $588.84 | $977.24 | $1,513.56 |
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 $281.84 Median $331.13 Typical High $354.81 | Professional | 52 · Reduced service | $281.84 | $331.13 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $131.83 Typical High $141.25 | Professional | 53 · Discontinued | $112.20 | $131.83 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $489.78 Typical High $537.03 | Professional | 54 · Surgery only | $426.58 | $489.78 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $97.72 Typical High $107.15 | Professional | 55 · Aftercare only | $85.11 | $97.72 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $66.07 Typical High $70.79 | Professional | 56 · Pre-op care only | $56.23 | $66.07 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $457.09 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $398.11 | $457.09 | $501.19 |
Where Georgia sits
The same service costs 6.2 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· 20th of 51
$891
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.