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 $741.31 Median $6,309.57 Typical High $10,000.00 | Facility | None | $741.31 | $6,309.57 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $912.01 | Professional | None | $741.31 | $741.31 | $912.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $1,148.15 Typical High $5,888.44 | Facility | None | $575.44 | $1,148.15 | $5,888.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $630.96 Median $1,023.29 Typical High $1,659.59 | Professional | None | $630.96 | $1,023.29 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,096.48 Median $1,548.82 Typical High $2,454.71 | Professional | 50 · Both sides | $1,096.48 | $1,548.82 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $457.09 Median $645.65 Typical High $1,047.13 | Professional | 62 · Two surgeons | $457.09 | $645.65 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,511.89 Typical High $3,162.28 | Facility | None | $630.96 | $2,511.89 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,122.02 Typical High $1,905.46 | Professional | None | $831.76 | $1,122.02 | $1,905.46 |
Kaiser Permanente Setting Professional Modifier None Typical Low $758.58 Median $851.14 Typical High $1,258.93 | Professional | None | $758.58 | $851.14 | $1,258.93 |
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 $630.96 Median $1,071.52 Typical High $1,819.70 | Professional | None | $630.96 | $1,071.52 | $1,819.70 |
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 $363.08 Median $371.54 Typical High $416.87 | Professional | 52 · Reduced service | $363.08 | $371.54 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $147.91 Typical High $165.96 | Professional | 53 · Discontinued | $144.54 | $147.91 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $616.60 | Professional | 54 · Surgery only | $549.54 | $549.54 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $112.20 Typical High $123.03 | Professional | 55 · Aftercare only | $109.65 | $112.20 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $74.13 Typical High $83.18 | Professional | 56 · Pre-op care only | $72.44 | $74.13 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $512.86 | $512.86 | $575.44 |
Where Georgia sits
The same service costs 7.6 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· 22nd of 51
$1,047
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.