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 $1,737.80 Median $5,623.41 Typical High $10,000.00 | Facility | None | $1,737.80 | $5,623.41 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $2,041.74 | Professional | None | $1,737.80 | $1,737.80 | $2,041.74 |
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 $1,445.44 Median $2,344.23 Typical High $3,801.89 | Professional | None | $1,445.44 | $2,344.23 | $3,801.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $269.15 Median $389.05 Typical High $645.65 | Professional | 80 · Assistant surgeon | $269.15 | $389.05 | $645.65 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $234.42 Median $338.84 Typical High $562.34 | Professional | AS · PA/NP assist | $234.42 | $338.84 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $4,365.16 Typical High $5,495.41 | Facility | None | $630.96 | $4,365.16 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $2,041.74 Median $2,754.23 Typical High $4,365.16 | Professional | None | $2,041.74 | $2,754.23 | $4,365.16 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,737.80 Median $1,949.84 Typical High $5,011.87 | Professional | None | $1,737.80 | $1,949.84 | $5,011.87 |
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 $1,513.56 Median $2,511.89 Typical High $4,365.16 | Professional | None | $1,513.56 | $2,511.89 | $4,365.16 |
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 $870.96 Median $870.96 Typical High $977.24 | Professional | 52 · Reduced service | $870.96 | $870.96 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $346.74 Typical High $389.05 | Professional | 53 · Discontinued | $346.74 | $346.74 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,318.26 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,318.26 | $1,318.26 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $263.03 Typical High $295.12 | Professional | 55 · Aftercare only | $263.03 | $263.03 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $173.78 Typical High $194.98 | Professional | 56 · Pre-op care only | $173.78 | $173.78 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,230.27 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,230.27 | $1,380.38 |
Where Georgia sits
The same service costs 18.2 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· 23rd of 51
$2,344
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.