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 $1,862.09 Median $5,623.41 Typical High $10,000.00 | Facility | None | $1,862.09 | $5,623.41 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $2,089.30 | Professional | None | $1,862.09 | $1,862.09 | $2,089.30 |
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 $1,621.81 Median $2,570.40 Typical High $4,073.80 | Professional | None | $1,621.81 | $2,570.40 | $4,073.80 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $288.40 Median $457.09 Typical High $676.08 | Professional | 80 · Assistant surgeon | $288.40 | $457.09 | $676.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $257.04 Median $371.54 Typical High $588.84 | Professional | AS · PA/NP assist | $257.04 | $371.54 | $588.84 |
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 $2,089.30 Median $3,090.30 Typical High $4,677.35 | Professional | None | $2,089.30 | $3,090.30 | $4,677.35 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,737.80 Median $1,995.26 Typical High $5,888.44 | Professional | None | $1,737.80 | $1,995.26 | $5,888.44 |
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 $1,698.24 Median $2,884.03 Typical High $4,570.88 | Professional | None | $1,698.24 | $2,884.03 | $4,570.88 |
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 $933.25 Median $933.25 Typical High $1,047.13 | Professional | 52 · Reduced service | $933.25 | $933.25 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $371.54 Typical High $416.87 | Professional | 53 · Discontinued | $371.54 | $371.54 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,380.38 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,380.38 | $1,380.38 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $275.42 Typical High $316.23 | Professional | 55 · Aftercare only | $275.42 | $275.42 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $186.21 Typical High $208.93 | Professional | 56 · Pre-op care only | $186.21 | $186.21 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,288.25 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,288.25 | $1,445.44 |
Where Georgia sits
The same service costs 20.0 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· 22nd of 51
$2,570
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.