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 $831.76 Median $5,011.87 Typical High $7,943.28 | Facility | None | $831.76 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $912.01 | Professional | None | $645.65 | $645.65 | $912.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $512.86 Median $1,000.00 Typical High $4,570.88 | Facility | None | $512.86 | $1,000.00 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $524.81 Median $891.25 Typical High $1,445.44 | Professional | None | $524.81 | $891.25 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $97.72 Median $141.25 Typical High $245.47 | Professional | 80 · Assistant surgeon | $97.72 | $141.25 | $245.47 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $87.10 Median $125.89 Typical High $204.17 | Professional | AS · PA/NP assist | $87.10 | $125.89 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,000.00 Typical High $1,348.96 | Facility | None | $524.81 | $1,000.00 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $977.24 Typical High $1,698.24 | Professional | None | $676.08 | $977.24 | $1,698.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $758.58 Typical High $1,258.93 | Professional | None | $676.08 | $758.58 | $1,258.93 |
Oscar Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,148.15 | $1,148.15 | $1,148.15 |
United Setting Facility Modifier None Typical Low $501.19 Median $724.44 Typical High $3,548.13 | Facility | None | $501.19 | $724.44 | $3,548.13 |
United Setting Professional Modifier None Typical Low $524.81 Median $851.14 Typical High $1,621.81 | Professional | None | $524.81 | $851.14 | $1,621.81 |
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 $316.23 Median $323.59 Typical High $363.08 | Professional | 52 · Reduced service | $316.23 | $323.59 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $128.82 Typical High $144.54 | Professional | 53 · Discontinued | $128.82 | $128.82 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $489.78 Typical High $537.03 | Professional | 54 · Surgery only | $478.63 | $489.78 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $97.72 Typical High $109.65 | Professional | 55 · Aftercare only | $95.50 | $97.72 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $64.57 Typical High $72.44 | Professional | 56 · Pre-op care only | $63.10 | $64.57 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $457.09 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $446.68 | $457.09 | $501.19 |
Where Georgia sits
The same service costs 7.4 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
$891
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.