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 $1,659.59 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,659.59 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,862.09 | Professional | None | $1,659.59 | $1,659.59 | $1,862.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $1,148.15 Typical High $5,754.40 | Facility | None | $575.44 | $1,148.15 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,479.11 Median $2,290.87 Typical High $3,630.78 | Professional | None | $1,479.11 | $2,290.87 | $3,630.78 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,023.29 Median $1,479.11 Typical High $2,398.83 | Professional | 62 · Two surgeons | $1,023.29 | $1,479.11 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $257.04 Median $398.11 Typical High $616.60 | Professional | 80 · Assistant surgeon | $257.04 | $398.11 | $616.60 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $229.09 Median $331.13 Typical High $537.03 | Professional | AS · PA/NP assist | $229.09 | $331.13 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $10,471.29 Typical High $12,882.50 | Facility | None | $630.96 | $10,471.29 | $12,882.50 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $2,570.40 Typical High $4,265.80 | Professional | None | $1,862.09 | $2,570.40 | $4,265.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,659.59 Median $1,862.09 Typical High $4,786.30 | Professional | None | $1,659.59 | $1,862.09 | $4,786.30 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $6,760.83 Typical High $12,882.50 | Facility | None | $1,513.56 | $6,760.83 | $12,882.50 |
United Setting Professional Modifier None Typical Low $1,479.11 Median $2,398.83 Typical High $4,365.16 | Professional | None | $1,479.11 | $2,398.83 | $4,365.16 |
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 $831.76 Median $831.76 Typical High $933.25 | Professional | 52 · Reduced service | $831.76 | $831.76 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $331.13 Typical High $371.54 | Professional | 53 · Discontinued | $331.13 | $331.13 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,258.93 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,258.93 | $1,258.93 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $251.19 Typical High $281.84 | Professional | 55 · Aftercare only | $251.19 | $251.19 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $165.96 Typical High $186.21 | Professional | 56 · Pre-op care only | $165.96 | $165.96 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,174.90 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,174.90 | $1,318.26 |
Where Georgia sits
The same service costs 20.4 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· 24th of 51
$2,291
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.