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 $1,122.02 Median $5,623.41 Typical High $10,000.00 | Facility | None | $1,122.02 | $5,623.41 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,122.02 Typical High $1,348.96 | Professional | None | $1,096.48 | $1,122.02 | $1,348.96 |
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 $1,288.25 Median $1,819.70 Typical High $2,511.89 | Professional | None | $1,288.25 | $1,819.70 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,905.46 Median $2,691.53 Typical High $3,890.45 | Professional | 50 · Both sides | $1,905.46 | $2,691.53 | $3,890.45 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $288.40 Typical High $416.87 | Professional | 80 · Assistant surgeon | $204.17 | $288.40 | $416.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $251.19 Typical High $363.08 | Professional | AS · PA/NP assist | $177.83 | $251.19 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $10,471.29 Typical High $13,182.57 | Facility | None | $602.56 | $10,471.29 | $13,182.57 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,698.24 Typical High $2,884.03 | Professional | None | $1,230.27 | $1,698.24 | $2,884.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,202.26 Median $1,819.70 Typical High $2,691.53 | Professional | None | $1,202.26 | $1,819.70 | $2,691.53 |
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 $954.99 Median $1,778.28 Typical High $2,951.21 | Professional | None | $954.99 | $1,778.28 | $2,951.21 |
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 $223.87 Typical High $245.47 | Professional | 53 · Discontinued | $218.78 | $223.87 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $831.76 Typical High $933.25 | Professional | 54 · Surgery only | $812.83 | $831.76 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $186.21 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $112.20 Typical High $123.03 | Professional | 56 · Pre-op care only | $109.65 | $112.20 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $776.25 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $758.58 | $776.25 | $870.96 |
Where Georgia sits
The same service costs 46.8 times more in Alaska than in Hawaii. 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· 16th of 51
$1,778
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.