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 $1,584.89 Median $5,623.41 Typical High $9,549.93 | Facility | None | $1,584.89 | $5,623.41 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,584.89 Typical High $1,949.84 | Professional | None | $1,548.82 | $1,584.89 | $1,949.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $1,412.54 Typical High $5,754.40 | Facility | None | $741.31 | $1,412.54 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,348.96 Median $2,137.96 Typical High $3,467.37 | Professional | None | $1,348.96 | $2,137.96 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,290.87 Median $3,235.94 Typical High $5,248.07 | Professional | 50 · Both sides | $2,290.87 | $3,235.94 | $5,248.07 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $239.88 Median $354.81 Typical High $588.84 | Professional | 80 · Assistant surgeon | $239.88 | $354.81 | $588.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $213.80 Median $302.00 Typical High $489.78 | Professional | AS · PA/NP assist | $213.80 | $302.00 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $1,905.46 Typical High $2,630.27 | Facility | None | $812.83 | $1,905.46 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $1,737.80 Median $2,344.23 Typical High $4,073.80 | Professional | None | $1,737.80 | $2,344.23 | $4,073.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,621.81 Median $1,819.70 Typical High $2,630.27 | Professional | None | $1,621.81 | $1,819.70 | $2,630.27 |
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 $1,318.26 Median $2,187.76 Typical High $3,890.45 | Professional | None | $1,318.26 | $2,187.76 | $3,890.45 |
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 $776.25 Median $794.33 Typical High $891.25 | Professional | 52 · Reduced service | $776.25 | $794.33 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $316.23 Typical High $354.81 | Professional | 53 · Discontinued | $309.03 | $316.23 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,202.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,174.90 | $1,202.26 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $239.88 Typical High $263.03 | Professional | 55 · Aftercare only | $234.42 | $239.88 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $158.49 Typical High $177.83 | Professional | 56 · Pre-op care only | $154.88 | $158.49 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,122.02 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,122.02 | $1,230.27 |
Where Georgia sits
The same service costs 15.8 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· 18th of 51
$2,138
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.