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 $1,698.24 Median $5,623.41 Typical High $10,000.00 | Facility | None | $1,698.24 | $5,623.41 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $1,698.24 Typical High $1,949.84 | Professional | None | $1,659.59 | $1,698.24 | $1,949.84 |
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 $1,380.38 Median $2,290.87 Typical High $3,630.78 | Professional | None | $1,380.38 | $2,290.87 | $3,630.78 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $263.03 Median $398.11 Typical High $616.60 | Professional | 80 · Assistant surgeon | $263.03 | $398.11 | $616.60 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $234.42 Median $331.13 Typical High $537.03 | Professional | AS · PA/NP assist | $234.42 | $331.13 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,265.80 Typical High $5,495.41 | Facility | None | $602.56 | $4,265.80 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $1,905.46 Median $2,691.53 Typical High $4,265.80 | Professional | None | $1,905.46 | $2,691.53 | $4,265.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,584.89 Median $1,819.70 Typical High $5,128.61 | Professional | None | $1,584.89 | $1,819.70 | $5,128.61 |
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 $2,454.71 Typical High $4,168.69 | Professional | None | $1,513.56 | $2,454.71 | $4,168.69 |
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 $851.14 Median $851.14 Typical High $954.99 | Professional | 52 · Reduced service | $851.14 | $851.14 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $338.84 Typical High $380.19 | Professional | 53 · Discontinued | $338.84 | $338.84 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,258.93 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,258.93 | $1,258.93 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $251.19 Typical High $281.84 | Professional | 55 · Aftercare only | $251.19 | $251.19 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $169.82 Typical High $190.55 | Professional | 56 · Pre-op care only | $169.82 | $169.82 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,174.90 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,174.90 | $1,318.26 |
Where Georgia sits
The same service costs 20.4 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· 24th of 51
$2,291
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.