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 $977.24 Median $5,623.41 Typical High $18,197.01 | Facility | None | $977.24 | $5,623.41 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $602.56 Typical High $933.25 | Professional | None | $588.84 | $602.56 | $933.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $1,148.15 Typical High $8,128.31 | Facility | None | $575.44 | $1,148.15 | $8,128.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $512.86 Median $812.83 Typical High $1,318.26 | Professional | None | $512.86 | $812.83 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $870.96 Median $1,230.27 Typical High $1,995.26 | Professional | 50 · Both sides | $870.96 | $1,230.27 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $371.54 Median $512.86 Typical High $831.76 | Professional | 62 · Two surgeons | $371.54 | $512.86 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,905.46 Typical High $2,511.89 | Facility | None | $602.56 | $1,905.46 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $912.01 Typical High $1,548.82 | Professional | None | $660.69 | $912.01 | $1,548.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $630.96 Median $691.83 Typical High $1,174.90 | Professional | None | $630.96 | $691.83 | $1,174.90 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,479.11 Typical High $5,011.87 | Facility | None | $851.14 | $1,479.11 | $5,011.87 |
United Setting Professional Modifier None Typical Low $512.86 Median $831.76 Typical High $1,479.11 | Professional | None | $512.86 | $831.76 | $1,479.11 |
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 $295.12 Median $302.00 Typical High $331.13 | Professional | 52 · Reduced service | $295.12 | $302.00 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $120.23 Typical High $134.90 | Professional | 53 · Discontinued | $120.23 | $120.23 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $446.68 Typical High $501.19 | Professional | 54 · Surgery only | $446.68 | $446.68 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $89.13 Typical High $100.00 | Professional | 55 · Aftercare only | $89.13 | $89.13 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $60.26 Typical High $66.07 | Professional | 56 · Pre-op care only | $58.88 | $60.26 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $416.87 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $416.87 | $416.87 | $467.74 |
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· 21st of 51
$851
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.