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 $870.96 Median $7,079.46 Typical High $12,302.69 | Facility | None | $870.96 | $7,079.46 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,122.02 | Professional | None | $870.96 | $870.96 | $1,122.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $1,698.24 Typical High $7,244.36 | Facility | None | $954.99 | $1,698.24 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $741.31 Median $1,202.26 Typical High $1,949.84 | Professional | None | $741.31 | $1,202.26 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $134.90 Median $208.93 Typical High $316.23 | Professional | 80 · Assistant surgeon | $134.90 | $208.93 | $316.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $169.82 Typical High $281.84 | Professional | AS · PA/NP assist | $123.03 | $169.82 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $1,122.02 Median $5,495.41 Typical High $7,244.36 | Facility | None | $1,122.02 | $5,495.41 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,380.38 Typical High $2,187.76 | Professional | None | $1,023.29 | $1,380.38 | $2,187.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $870.96 Median $977.24 Typical High $4,365.16 | Professional | None | $870.96 | $977.24 | $4,365.16 |
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 $776.25 Median $1,258.93 Typical High $2,238.72 | Professional | None | $776.25 | $1,258.93 | $2,238.72 |
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 $436.52 Median $436.52 Typical High $489.78 | Professional | 52 · Reduced service | $436.52 | $436.52 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $194.98 | Professional | 53 · Discontinued | $173.78 | $173.78 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $660.69 Typical High $724.44 | Professional | 54 · Surgery only | $645.65 | $660.69 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $147.91 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $97.72 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $616.60 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $602.56 | $616.60 | $676.08 |
Where Georgia sits
The same service costs 17.8 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
$1,259
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.