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 $2,344.23 Median $5,623.41 Typical High $10,000.00 | Facility | None | $2,344.23 | $5,623.41 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,630.27 | Professional | None | $2,344.23 | $2,344.23 | $2,630.27 |
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 $1,995.26 Median $3,162.28 Typical High $5,128.61 | Professional | None | $1,995.26 | $3,162.28 | $5,128.61 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,445.44 Median $2,089.30 Typical High $3,311.31 | Professional | 62 · Two surgeons | $1,445.44 | $2,089.30 | $3,311.31 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $371.54 Median $562.34 Typical High $870.96 | Professional | 80 · Assistant surgeon | $371.54 | $562.34 | $870.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $316.23 Median $467.74 Typical High $758.58 | Professional | AS · PA/NP assist | $316.23 | $467.74 | $758.58 |
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 $2,691.53 Median $3,715.35 Typical High $6,025.60 | Professional | None | $2,691.53 | $3,715.35 | $6,025.60 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,290.87 Median $2,570.40 Typical High $7,079.46 | Professional | None | $2,290.87 | $2,570.40 | $7,079.46 |
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 $2,089.30 Median $3,467.37 Typical High $5,888.44 | Professional | None | $2,089.30 | $3,467.37 | $5,888.44 |
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 $1,174.90 Median $1,174.90 Typical High $1,318.26 | Professional | 52 · Reduced service | $1,174.90 | $1,174.90 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $467.74 Typical High $537.03 | Professional | 53 · Discontinued | $467.74 | $467.74 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $1,778.28 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,778.28 | $1,778.28 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $354.81 Typical High $398.11 | Professional | 55 · Aftercare only | $354.81 | $354.81 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $234.42 Typical High $263.03 | Professional | 56 · Pre-op care only | $234.42 | $234.42 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $1,659.59 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,659.59 | $1,659.59 | $1,862.09 |
Where Georgia sits
The same service costs 21.9 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· 21st of 51
$3,162
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.