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 $2,187.76 Median $7,079.46 Typical High $19,952.62 | Facility | None | $2,187.76 | $7,079.46 | $19,952.62 |
Aetna Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,691.53 | Professional | None | $2,187.76 | $2,187.76 | $2,691.53 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,071.52 Median $1,905.46 Typical High $12,589.25 | Facility | None | $1,071.52 | $1,905.46 | $12,589.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,949.84 Median $3,019.95 Typical High $4,897.79 | Professional | None | $1,949.84 | $3,019.95 | $4,897.79 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,380.38 Median $1,949.84 Typical High $3,235.94 | Professional | 62 · Two surgeons | $1,380.38 | $1,949.84 | $3,235.94 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $338.84 Median $524.81 Typical High $812.83 | Professional | 80 · Assistant surgeon | $338.84 | $524.81 | $812.83 |
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 $630.96 Median $10,471.29 Typical High $12,882.50 | Facility | None | $630.96 | $10,471.29 | $12,882.50 |
Cigna Setting Professional Modifier None Typical Low $2,511.89 Median $3,548.13 Typical High $5,623.41 | Professional | None | $2,511.89 | $3,548.13 | $5,623.41 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,187.76 Median $2,454.71 Typical High $8,511.38 | Professional | None | $2,187.76 | $2,454.71 | $8,511.38 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $6,760.83 Typical High $12,882.50 | Facility | None | $1,513.56 | $6,760.83 | $12,882.50 |
United Setting Professional Modifier None Typical Low $1,995.26 Median $3,235.94 Typical High $5,495.41 | Professional | None | $1,995.26 | $3,235.94 | $5,495.41 |
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 $1,096.48 Median $1,096.48 Typical High $1,258.93 | Professional | 52 · Reduced service | $1,096.48 | $1,096.48 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $446.68 Typical High $501.19 | Professional | 53 · Discontinued | $446.68 | $446.68 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $1,659.59 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,659.59 | $1,659.59 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $331.13 Typical High $371.54 | Professional | 55 · Aftercare only | $331.13 | $331.13 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $218.78 Typical High $251.19 | Professional | 56 · Pre-op care only | $218.78 | $218.78 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,548.82 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,548.82 | $1,737.80 |
Where Georgia sits
The same service costs 6.5 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
$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.