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 $1,000.00 Median $5,370.32 Typical High $8,317.64 | Facility | None | $1,000.00 | $5,370.32 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $691.83 Typical High $1,513.56 | Professional | None | $676.08 | $691.83 | $1,513.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $691.83 Median $1,380.38 Typical High $7,244.36 | Facility | None | $691.83 | $1,380.38 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $575.44 Median $933.25 Typical High $1,548.82 | Professional | None | $575.44 | $933.25 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $154.88 Typical High $251.19 | Professional | 80 · Assistant surgeon | $107.15 | $154.88 | $251.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $131.83 Typical High $223.87 | Professional | AS · PA/NP assist | $93.33 | $131.83 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $3,388.44 Typical High $4,365.16 | Facility | None | $741.31 | $3,388.44 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $1,096.48 Typical High $1,737.80 | Professional | None | $758.58 | $1,096.48 | $1,737.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $707.95 Median $776.25 Typical High $1,288.25 | Professional | None | $707.95 | $776.25 | $1,288.25 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,479.11 Typical High $5,011.87 | Facility | None | $851.14 | $1,479.11 | $5,011.87 |
United Setting Professional Modifier None Typical Low $630.96 Median $1,047.13 Typical High $1,659.59 | Professional | None | $630.96 | $1,047.13 | $1,659.59 |
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 $338.84 Median $346.74 Typical High $380.19 | Professional | 52 · Reduced service | $338.84 | $346.74 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $138.04 Typical High $151.36 | Professional | 53 · Discontinued | $134.90 | $138.04 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $524.81 Typical High $562.34 | Professional | 54 · Surgery only | $501.19 | $524.81 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $104.71 Typical High $114.82 | Professional | 55 · Aftercare only | $102.33 | $104.71 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $69.18 Typical High $75.86 | Professional | 56 · Pre-op care only | $67.61 | $69.18 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $489.78 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $467.74 | $489.78 | $524.81 |
Where Georgia sits
The same service costs 8.1 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· 23rd of 51
$955
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.