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 $1,202.26 Median $5,623.41 Typical High $18,197.01 | Facility | None | $1,202.26 | $5,623.41 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,318.26 | Professional | None | $933.25 | $933.25 | $1,318.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,548.82 Typical High $12,302.69 | Facility | None | $588.84 | $1,548.82 | $12,302.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $794.33 Median $1,288.25 Typical High $2,089.30 | Professional | None | $794.33 | $1,288.25 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,380.38 Median $1,949.84 Typical High $3,162.28 | Professional | 50 · Both sides | $1,380.38 | $1,949.84 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $223.87 Typical High $354.81 | Professional | 80 · Assistant surgeon | $147.91 | $223.87 | $354.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $181.97 Typical High $302.00 | Professional | AS · PA/NP assist | $128.82 | $181.97 | $302.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $977.24 Median $1,096.48 Typical High $1,862.09 | Professional | None | $977.24 | $1,096.48 | $1,862.09 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $2,884.03 Typical High $8,709.64 | Facility | None | $1,258.93 | $2,884.03 | $8,709.64 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,348.96 Typical High $2,344.23 | Professional | None | $831.76 | $1,348.96 | $2,344.23 |
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 $467.74 Median $467.74 Typical High $524.81 | Professional | 52 · Reduced service | $467.74 | $467.74 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $190.55 Typical High $208.93 | Professional | 53 · Discontinued | $186.21 | $190.55 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $707.95 Typical High $794.33 | Professional | 54 · Surgery only | $691.83 | $707.95 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $158.49 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $93.33 Typical High $104.71 | Professional | 56 · Pre-op care only | $93.33 | $93.33 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $660.69 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $645.65 | $660.69 | $741.31 |
Where Georgia sits
The same service costs 17.4 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· 22nd of 51
$1,288
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.