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 $1,412.54 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,412.54 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,584.89 | Professional | None | $1,412.54 | $1,412.54 | $1,584.89 |
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 $1,148.15 Median $1,905.46 Typical High $3,090.30 | Professional | None | $1,148.15 | $1,905.46 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $851.14 Median $1,230.27 Typical High $1,949.84 | Professional | 62 · Two surgeons | $851.14 | $1,230.27 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $309.03 Typical High $512.86 | Professional | 80 · Assistant surgeon | $213.80 | $309.03 | $512.86 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $263.03 Typical High $426.58 | Professional | AS · PA/NP assist | $186.21 | $263.03 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,467.37 Typical High $4,365.16 | Facility | None | $602.56 | $3,467.37 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $2,187.76 Typical High $3,548.13 | Professional | None | $1,584.89 | $2,187.76 | $3,548.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,412.54 Median $1,584.89 Typical High $4,786.30 | Professional | None | $1,412.54 | $1,584.89 | $4,786.30 |
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 $1,202.26 Median $1,949.84 Typical High $3,548.13 | Professional | None | $1,202.26 | $1,949.84 | $3,548.13 |
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 $707.95 Median $707.95 Typical High $794.33 | Professional | 52 · Reduced service | $707.95 | $707.95 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $288.40 Typical High $316.23 | Professional | 53 · Discontinued | $281.84 | $288.40 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,071.52 Typical High $1,174.90 | Professional | 54 · Surgery only | $1,047.13 | $1,071.52 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $213.80 Typical High $239.88 | Professional | 55 · Aftercare only | $213.80 | $213.80 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $158.49 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,000.00 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $977.24 | $1,000.00 | $1,096.48 |
Where Georgia sits
The same service costs 17.0 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
$1,905
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.