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 $630.96 Median $3,548.13 Typical High $7,585.78 | Facility | None | $630.96 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $436.52 Typical High $1,148.15 | Professional | None | $426.58 | $436.52 | $1,148.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $1,000.00 Typical High $5,754.40 | Facility | None | $389.05 | $1,000.00 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $398.11 Median $602.56 Typical High $977.24 | Professional | None | $398.11 | $602.56 | $977.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $645.65 Median $891.25 Typical High $1,445.44 | Professional | 50 · Both sides | $645.65 | $891.25 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $269.15 Median $380.19 Typical High $616.60 | Professional | 62 · Two surgeons | $269.15 | $380.19 | $616.60 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $67.61 Median $100.00 Typical High $162.18 | Professional | 80 · Assistant surgeon | $67.61 | $100.00 | $162.18 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $60.26 Median $83.18 Typical High $134.90 | Professional | AS · PA/NP assist | $60.26 | $83.18 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $1,862.09 Typical High $2,344.23 | Facility | None | $398.11 | $1,862.09 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $645.65 Typical High $1,122.02 | Professional | None | $478.63 | $645.65 | $1,122.02 |
Kaiser Permanente Setting Professional Modifier None Typical Low $467.74 Median $512.86 Typical High $954.99 | Professional | None | $467.74 | $512.86 | $954.99 |
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 $371.54 Median $616.60 Typical High $1,096.48 | Professional | None | $371.54 | $616.60 | $1,096.48 |
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 $213.80 Median $218.78 Typical High $239.88 | Professional | 52 · Reduced service | $213.80 | $218.78 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $87.10 Typical High $95.50 | Professional | 53 · Discontinued | $85.11 | $87.10 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $323.59 Typical High $363.08 | Professional | 54 · Surgery only | $323.59 | $323.59 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $64.57 Typical High $72.44 | Professional | 55 · Aftercare only | $64.57 | $64.57 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $43.65 Typical High $47.86 | Professional | 56 · Pre-op care only | $42.66 | $43.65 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $302.00 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $302.00 | $302.00 | $338.84 |
Where Georgia sits
The same service costs 8.3 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· 22nd of 51
$617
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.