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 $831.76 Median $831.76 Typical High $1,122.02 | Professional | None | $831.76 | $831.76 | $1,122.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $512.86 Median $1,071.52 Typical High $5,754.40 | Facility | None | $512.86 | $1,071.52 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $724.44 Median $1,148.15 Typical High $1,862.09 | Professional | None | $724.44 | $1,148.15 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $181.97 Typical High $309.03 | Professional | 80 · Assistant surgeon | $125.89 | $181.97 | $309.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $162.18 Typical High $257.04 | Professional | AS · PA/NP assist | $112.20 | $162.18 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,905.46 Typical High $2,344.23 | Facility | None | $524.81 | $1,905.46 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,174.90 Typical High $2,187.76 | Professional | None | $851.14 | $1,174.90 | $2,187.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $891.25 Median $977.24 Typical High $1,479.11 | Professional | None | $891.25 | $977.24 | $1,479.11 |
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 $691.83 Median $1,148.15 Typical High $2,089.30 | Professional | None | $691.83 | $1,148.15 | $2,089.30 |
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 $407.38 Median $416.87 Typical High $467.74 | Professional | 52 · Reduced service | $407.38 | $416.87 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $169.82 Typical High $186.21 | Professional | 53 · Discontinued | $162.18 | $169.82 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $630.96 Typical High $691.83 | Professional | 54 · Surgery only | $616.60 | $630.96 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $125.89 Typical High $138.04 | Professional | 55 · Aftercare only | $123.03 | $125.89 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $83.18 Typical High $93.33 | Professional | 56 · Pre-op care only | $81.28 | $83.18 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $588.84 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $575.44 | $588.84 | $645.65 |
Where Georgia sits
The same service costs 8.3 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· 19th of 51
$1,148
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.