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 $954.99 Median $5,370.32 Typical High $7,943.28 | Facility | None | $954.99 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,071.52 | Professional | None | $954.99 | $954.99 | $1,071.52 |
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 $794.33 Median $1,318.26 Typical High $2,137.96 | Professional | None | $794.33 | $1,318.26 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,348.96 Median $1,949.84 Typical High $3,162.28 | Professional | 50 · Both sides | $1,348.96 | $1,949.84 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $218.78 Typical High $354.81 | Professional | 80 · Assistant surgeon | $144.54 | $218.78 | $354.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $181.97 Typical High $295.12 | Professional | AS · PA/NP assist | $125.89 | $181.97 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $10,715.19 Typical High $13,182.57 | Facility | None | $630.96 | $10,715.19 | $13,182.57 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,479.11 Typical High $2,454.71 | Professional | None | $1,023.29 | $1,479.11 | $2,454.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $977.24 Median $1,096.48 Typical High $2,187.76 | Professional | None | $977.24 | $1,096.48 | $2,187.76 |
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 $794.33 Median $1,258.93 Typical High $2,398.83 | Professional | None | $794.33 | $1,258.93 | $2,398.83 |
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 $478.63 Median $478.63 Typical High $537.03 | Professional | 52 · Reduced service | $478.63 | $478.63 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $213.80 | Professional | 53 · Discontinued | $190.55 | $190.55 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $724.44 Typical High $812.83 | Professional | 54 · Surgery only | $707.95 | $724.44 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $144.54 Typical High $162.18 | Professional | 55 · Aftercare only | $141.25 | $144.54 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $107.15 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $676.08 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $660.69 | $676.08 | $758.58 |
Where Georgia sits
The same service costs 16.2 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· 21st of 51
$1,318
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.