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 $1,047.13 Median $5,623.41 Typical High $10,000.00 | Facility | None | $1,047.13 | $5,623.41 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,258.93 | Professional | None | $1,047.13 | $1,047.13 | $1,258.93 |
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 $977.24 Median $1,445.44 Typical High $2,398.83 | Professional | None | $977.24 | $1,445.44 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $660.69 Median $954.99 Typical High $1,548.82 | Professional | 62 · Two surgeons | $660.69 | $954.99 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $263.03 Typical High $398.11 | Professional | 80 · Assistant surgeon | $162.18 | $263.03 | $398.11 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $213.80 Typical High $346.74 | Professional | AS · PA/NP assist | $147.91 | $213.80 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $5,248.07 Typical High $6,760.83 | Facility | None | $602.56 | $5,248.07 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,778.28 Typical High $2,754.23 | Professional | None | $1,202.26 | $1,778.28 | $2,754.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,122.02 Median $1,288.25 Typical High $2,570.40 | Professional | None | $1,122.02 | $1,288.25 | $2,570.40 |
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 $954.99 Median $1,548.82 Typical High $2,754.23 | Professional | None | $954.99 | $1,548.82 | $2,754.23 |
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 $524.81 Median $524.81 Typical High $602.56 | Professional | 52 · Reduced service | $524.81 | $524.81 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $208.93 Typical High $239.88 | Professional | 53 · Discontinued | $208.93 | $208.93 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $891.25 | Professional | 54 · Surgery only | $794.33 | $794.33 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $177.83 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $120.23 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $741.31 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $741.31 | $741.31 | $831.76 |
Where Georgia sits
The same service costs 14.8 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· 24th of 51
$1,514
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.