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 $1,202.26 Median $5,623.41 Typical High $9,549.93 | Facility | None | $1,202.26 | $5,623.41 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,318.26 | Professional | None | $1,096.48 | $1,096.48 | $1,318.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $812.83 Median $1,737.80 Typical High $11,748.98 | Facility | None | $812.83 | $1,737.80 | $11,748.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,479.11 Typical High $2,398.83 | Professional | None | $912.01 | $1,479.11 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,584.89 Median $2,290.87 Typical High $3,715.35 | Professional | 50 · Both sides | $1,584.89 | $2,290.87 | $3,715.35 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $257.04 Typical High $407.38 | Professional | 80 · Assistant surgeon | $169.82 | $257.04 | $407.38 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $213.80 Typical High $354.81 | Professional | AS · PA/NP assist | $147.91 | $213.80 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $10,471.29 Typical High $13,489.63 | Facility | None | $812.83 | $10,471.29 | $13,489.63 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,737.80 Typical High $2,818.38 | Professional | None | $1,230.27 | $1,737.80 | $2,818.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,096.48 Median $1,230.27 Typical High $3,019.95 | Professional | None | $1,096.48 | $1,230.27 | $3,019.95 |
Oscar Health Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,905.46 | Professional | None | $1,862.09 | $1,862.09 | $1,905.46 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $2,884.03 Typical High $8,709.64 | Facility | None | $1,258.93 | $2,884.03 | $8,709.64 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,584.89 Typical High $2,691.53 | Professional | None | $954.99 | $1,584.89 | $2,691.53 |
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 $549.54 Median $549.54 Typical High $616.60 | Professional | 52 · Reduced service | $549.54 | $549.54 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $245.47 | Professional | 53 · Discontinued | $218.78 | $218.78 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $912.01 | Professional | 54 · Surgery only | $812.83 | $812.83 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $181.97 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $123.03 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $851.14 |
Where Georgia sits
The same service costs 7.9 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
$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.