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 $2,884.03 Median $5,623.41 Typical High $10,000.00 | Facility | None | $2,884.03 | $5,623.41 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $3,235.94 | Professional | None | $2,884.03 | $2,884.03 | $3,235.94 |
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 $2,511.89 Median $3,890.45 Typical High $6,309.57 | Professional | None | $2,511.89 | $3,890.45 | $6,309.57 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $446.68 Median $691.83 Typical High $1,047.13 | Professional | 80 · Assistant surgeon | $446.68 | $691.83 | $1,047.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $389.05 Median $575.44 Typical High $912.01 | Professional | AS · PA/NP assist | $389.05 | $575.44 | $912.01 |
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 $3,235.94 Median $4,677.35 Typical High $7,244.36 | Professional | None | $3,235.94 | $4,677.35 | $7,244.36 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,691.53 Median $3,090.30 Typical High $10,000.00 | Professional | None | $2,691.53 | $3,090.30 | $10,000.00 |
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 $2,570.40 Median $4,265.80 Typical High $7,079.46 | Professional | None | $2,570.40 | $4,265.80 | $7,079.46 |
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 $1,445.44 Median $1,445.44 Typical High $1,621.81 | Professional | 52 · Reduced service | $1,445.44 | $1,445.44 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $575.44 Median $575.44 Typical High $645.65 | Professional | 53 · Discontinued | $575.44 | $575.44 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,137.96 Median $2,137.96 Typical High $2,454.71 | Professional | 54 · Surgery only | $2,137.96 | $2,137.96 | $2,454.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $426.58 Median $426.58 Typical High $489.78 | Professional | 55 · Aftercare only | $426.58 | $426.58 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $288.40 Median $288.40 Typical High $323.59 | Professional | 56 · Pre-op care only | $288.40 | $288.40 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,995.26 Median $1,995.26 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $1,995.26 | $1,995.26 | $2,290.87 |
Where Georgia sits
The same service costs 20.9 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
$3,890
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.