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 $724.44 Median $6,309.57 Typical High $10,000.00 | Facility | None | $724.44 | $6,309.57 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $891.25 | Professional | None | $724.44 | $724.44 | $891.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $1,148.15 Typical High $5,754.40 | Facility | None | $575.44 | $1,148.15 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $707.95 Median $1,023.29 Typical High $1,698.24 | Professional | None | $707.95 | $1,023.29 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,122.02 Median $1,659.59 Typical High $2,570.40 | Professional | 50 · Both sides | $1,122.02 | $1,659.59 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $190.55 Typical High $275.42 | Professional | 80 · Assistant surgeon | $114.82 | $190.55 | $275.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $147.91 Typical High $239.88 | Professional | AS · PA/NP assist | $104.71 | $147.91 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,265.80 Typical High $5,370.32 | Facility | None | $602.56 | $4,265.80 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,230.27 Typical High $1,905.46 | Professional | None | $831.76 | $1,230.27 | $1,905.46 |
Kaiser Permanente Setting Professional Modifier None Typical Low $758.58 Median $870.96 Typical High $2,290.87 | Professional | None | $758.58 | $870.96 | $2,290.87 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $3,715.35 Typical High $9,549.93 | Facility | None | $1,513.56 | $3,715.35 | $9,549.93 |
United Setting Professional Modifier None Typical Low $707.95 Median $1,202.26 Typical High $1,862.09 | Professional | None | $707.95 | $1,202.26 | $1,862.09 |
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 $363.08 Median $363.08 Typical High $416.87 | Professional | 52 · Reduced service | $363.08 | $363.08 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $165.96 | Professional | 53 · Discontinued | $144.54 | $144.54 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $537.03 Typical High $616.60 | Professional | 54 · Surgery only | $537.03 | $537.03 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $123.03 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $83.18 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $501.19 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $501.19 | $501.19 | $575.44 |
Where Georgia sits
The same service costs 7.2 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· 24th of 51
$1,096
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.