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 $5,370.32 Typical High $7,943.28 | Facility | None | $2,344.23 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $2,290.87 Median $2,344.23 Typical High $2,570.40 | Professional | None | $2,290.87 | $2,344.23 | $2,570.40 |
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 $1,862.09 Median $3,090.30 Typical High $5,011.87 | Professional | None | $1,862.09 | $3,090.30 | $5,011.87 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,380.38 Median $1,949.84 Typical High $3,162.28 | Professional | 62 · Two surgeons | $1,380.38 | $1,949.84 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $338.84 Median $512.86 Typical High $851.14 | Professional | 80 · Assistant surgeon | $338.84 | $512.86 | $851.14 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $309.03 Median $436.52 Typical High $707.95 | Professional | AS · PA/NP assist | $309.03 | $436.52 | $707.95 |
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 $2,511.89 Median $3,630.78 Typical High $5,888.44 | Professional | None | $2,511.89 | $3,630.78 | $5,888.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,290.87 Median $2,570.40 Typical High $8,912.51 | Professional | None | $2,290.87 | $2,570.40 | $8,912.51 |
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 $1,905.46 Median $3,090.30 Typical High $5,754.40 | Professional | None | $1,905.46 | $3,090.30 | $5,754.40 |
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 $1,148.15 Median $1,174.90 Typical High $1,288.25 | Professional | 52 · Reduced service | $1,148.15 | $1,174.90 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $467.74 Typical High $524.81 | Professional | 53 · Discontinued | $457.09 | $467.74 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $1,737.80 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,737.80 | $1,737.80 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $346.74 Typical High $389.05 | Professional | 55 · Aftercare only | $346.74 | $346.74 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $234.42 Typical High $257.04 | Professional | 56 · Pre-op care only | $229.09 | $234.42 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,621.81 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,621.81 | $1,819.70 |
Where Georgia sits
The same service costs 21.4 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· 18th of 51
$3,090
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.