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 $6,760.83 Typical High $18,197.01 | Facility | None | $1,202.26 | $6,760.83 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $691.83 Typical High $1,071.52 | Professional | None | $676.08 | $691.83 | $1,071.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,071.52 Median $1,905.46 Typical High $12,302.69 | Facility | None | $1,071.52 | $1,905.46 | $12,302.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $588.84 Median $933.25 Typical High $1,513.56 | Professional | None | $588.84 | $933.25 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,000.00 Median $1,445.44 Typical High $2,344.23 | Professional | 50 · Both sides | $1,000.00 | $1,445.44 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $426.58 Median $616.60 Typical High $977.24 | Professional | 62 · Two surgeons | $426.58 | $616.60 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,265.80 Typical High $5,370.32 | Facility | None | $602.56 | $4,265.80 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $1,047.13 Typical High $1,778.28 | Professional | None | $758.58 | $1,047.13 | $1,778.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $707.95 Median $794.33 Typical High $1,949.84 | Professional | None | $707.95 | $794.33 | $1,949.84 |
Oscar Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,202.26 | $1,202.26 | $1,202.26 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $7,585.78 | Facility | None | $954.99 | $1,995.26 | $7,585.78 |
United Setting Professional Modifier None Typical Low $602.56 Median $977.24 Typical High $1,698.24 | Professional | None | $602.56 | $977.24 | $1,698.24 |
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 $338.84 Median $338.84 Typical High $380.19 | Professional | 52 · Reduced service | $338.84 | $338.84 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $138.04 Typical High $151.36 | Professional | 53 · Discontinued | $134.90 | $138.04 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $575.44 | Professional | 54 · Surgery only | $512.86 | $512.86 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $114.82 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $69.18 Typical High $75.86 | Professional | 56 · Pre-op care only | $67.61 | $69.18 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $478.63 | $478.63 | $537.03 |
Where Georgia sits
The same service costs 8.1 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· 23rd of 51
$1,000
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.