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 $5,370.32 Typical High $7,943.28 | Facility | None | $977.24 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,000.00 | Professional | None | $741.31 | $741.31 | $1,000.00 |
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 $588.84 Median $1,000.00 Typical High $1,621.81 | Professional | None | $588.84 | $1,000.00 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $446.68 Median $645.65 Typical High $1,047.13 | Professional | 62 · Two surgeons | $446.68 | $645.65 | $1,047.13 |
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 $831.76 Median $1,148.15 Typical High $1,905.46 | Professional | None | $831.76 | $1,148.15 | $1,905.46 |
Kaiser Permanente Setting Professional Modifier None Typical Low $741.31 Median $851.14 Typical High $1,288.25 | Professional | None | $741.31 | $851.14 | $1,288.25 |
Oscar Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $1,288.25 | Professional | None | $1,122.02 | $1,258.93 | $1,288.25 |
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 $645.65 Median $1,000.00 Typical High $1,737.80 | Professional | None | $645.65 | $1,000.00 | $1,737.80 |
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 $371.54 Median $371.54 Typical High $426.58 | Professional | 52 · Reduced service | $371.54 | $371.54 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $169.82 | Professional | 53 · Discontinued | $147.91 | $147.91 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $630.96 | Professional | 54 · Surgery only | $562.34 | $562.34 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $125.89 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $85.11 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $588.84 |
Where Georgia sits
The same service costs 6.6 times more in Alaska than in Utah. 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· 25th 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.