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 $851.14 Median $5,370.32 Typical High $7,943.28 | Facility | None | $851.14 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $588.84 Typical High $851.14 | Professional | None | $575.44 | $588.84 | $851.14 |
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 $501.19 Median $812.83 Typical High $1,318.26 | Professional | None | $501.19 | $812.83 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $870.96 Median $1,202.26 Typical High $1,949.84 | Professional | 50 · Both sides | $870.96 | $1,202.26 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $91.20 Median $134.90 Typical High $218.78 | Professional | 80 · Assistant surgeon | $91.20 | $134.90 | $218.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $81.28 Median $112.20 Typical High $186.21 | Professional | AS · PA/NP assist | $81.28 | $112.20 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,905.46 Typical High $2,511.89 | Facility | None | $602.56 | $1,905.46 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $891.25 Typical High $1,513.56 | Professional | None | $645.65 | $891.25 | $1,513.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $616.60 Median $691.83 Typical High $1,096.48 | Professional | None | $616.60 | $691.83 | $1,096.48 |
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 $512.86 Median $851.14 Typical High $1,445.44 | Professional | None | $512.86 | $851.14 | $1,445.44 |
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 $288.40 Median $295.12 Typical High $323.59 | Professional | 52 · Reduced service | $288.40 | $295.12 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $117.49 Typical High $131.83 | Professional | 53 · Discontinued | $114.82 | $117.49 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $436.52 Typical High $489.78 | Professional | 54 · Surgery only | $436.52 | $436.52 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $89.13 Typical High $97.72 | Professional | 55 · Aftercare only | $87.10 | $89.13 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $58.88 Typical High $64.57 | Professional | 56 · Pre-op care only | $57.54 | $58.88 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $407.38 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $407.38 | $407.38 | $457.09 |
Where Georgia sits
The same service costs 8.9 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· 22nd of 51
$832
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.