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 $1,380.38 Median $5,623.41 Typical High $10,000.00 | Facility | None | $1,380.38 | $5,623.41 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,380.38 Typical High $2,951.21 | Professional | None | $1,348.96 | $1,380.38 | $2,951.21 |
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 $1,174.90 Median $1,862.09 Typical High $2,951.21 | Professional | None | $1,174.90 | $1,862.09 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $851.14 Median $1,202.26 Typical High $1,949.84 | Professional | 62 · Two surgeons | $851.14 | $1,202.26 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $323.59 Typical High $501.19 | Professional | 80 · Assistant surgeon | $208.93 | $323.59 | $501.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $269.15 Typical High $436.52 | Professional | AS · PA/NP assist | $181.97 | $269.15 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $3,467.37 Typical High $4,365.16 | Facility | None | $630.96 | $3,467.37 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $2,187.76 Typical High $3,467.37 | Professional | None | $1,584.89 | $2,187.76 | $3,467.37 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,348.96 Median $1,513.56 Typical High $4,168.69 | Professional | None | $1,348.96 | $1,513.56 | $4,168.69 |
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 $1,202.26 Median $1,995.26 Typical High $3,388.44 | Professional | None | $1,202.26 | $1,995.26 | $3,388.44 |
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 $676.08 Median $691.83 Typical High $758.58 | Professional | 52 · Reduced service | $676.08 | $691.83 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $275.42 Typical High $302.00 | Professional | 53 · Discontinued | $269.15 | $275.42 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,023.29 Typical High $1,148.15 | Professional | 54 · Surgery only | $1,023.29 | $1,023.29 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $204.17 Typical High $229.09 | Professional | 55 · Aftercare only | $204.17 | $204.17 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $138.04 Typical High $151.36 | Professional | 56 · Pre-op care only | $134.90 | $138.04 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $954.99 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $954.99 | $954.99 | $1,071.52 |
Where Georgia sits
The same service costs 15.1 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· 25th of 51
$1,862
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.