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 $707.95 Median $3,548.13 Typical High $7,585.78 | Facility | None | $707.95 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $707.95 Typical High $851.14 | Professional | None | $676.08 | $707.95 | $851.14 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $1,000.00 Typical High $5,754.40 | Facility | None | $389.05 | $1,000.00 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $602.56 Median $954.99 Typical High $1,513.56 | Professional | None | $602.56 | $954.99 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $162.18 Typical High $257.04 | Professional | 80 · Assistant surgeon | $104.71 | $162.18 | $257.04 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $95.50 Median $131.83 Typical High $213.80 | Professional | AS · PA/NP assist | $95.50 | $131.83 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $1,862.09 Typical High $2,344.23 | Facility | None | $398.11 | $1,862.09 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $954.99 Typical High $1,778.28 | Professional | None | $707.95 | $954.99 | $1,778.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $758.58 Median $831.76 Typical High $1,202.26 | Professional | None | $758.58 | $831.76 | $1,202.26 |
Oscar Health Setting Professional Modifier None Typical Low $707.95 Median $1,174.90 Typical High $1,513.56 | Professional | None | $707.95 | $1,174.90 | $1,513.56 |
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 $575.44 Median $954.99 Typical High $1,778.28 | Professional | None | $575.44 | $954.99 | $1,778.28 |
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 $338.84 Median $354.81 Typical High $380.19 | Professional | 52 · Reduced service | $338.84 | $354.81 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $141.25 Typical High $151.36 | Professional | 53 · Discontinued | $134.90 | $141.25 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $524.81 Typical High $575.44 | Professional | 54 · Surgery only | $501.19 | $524.81 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $104.71 Typical High $114.82 | Professional | 55 · Aftercare only | $100.00 | $104.71 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $70.79 Typical High $75.86 | Professional | 56 · Pre-op care only | $67.61 | $70.79 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $489.78 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $467.74 | $489.78 | $537.03 |
Where Georgia sits
The same service costs 7.8 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· 20th of 51
$955
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.