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 $1,380.38 Median $6,760.83 Typical High $13,803.84 | Facility | None | $1,380.38 | $6,760.83 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $645.65 Typical High $776.25 | Professional | None | $630.96 | $645.65 | $776.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $660.69 Median $1,202.26 Typical High $7,079.46 | Facility | None | $660.69 | $1,202.26 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $549.54 Median $891.25 Typical High $1,445.44 | Professional | None | $549.54 | $891.25 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $954.99 Median $1,318.26 Typical High $2,137.96 | Professional | 50 · Both sides | $954.99 | $1,318.26 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $398.11 Median $549.54 Typical High $912.01 | Professional | 62 · Two surgeons | $398.11 | $549.54 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,047.13 Typical High $2,951.21 | Facility | None | $741.31 | $1,047.13 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $977.24 Typical High $1,659.59 | Professional | None | $707.95 | $977.24 | $1,659.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $741.31 Typical High $1,778.28 | Professional | None | $676.08 | $741.31 | $1,778.28 |
Oscar Health Setting Professional Modifier None Typical Low $645.65 Median $1,096.48 Typical High $1,348.96 | Professional | None | $645.65 | $1,096.48 | $1,348.96 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $1,995.26 Typical High $7,943.28 | Facility | None | $1,000.00 | $1,995.26 | $7,943.28 |
United Setting Professional Modifier None Typical Low $549.54 Median $891.25 Typical High $1,584.89 | Professional | None | $549.54 | $891.25 | $1,584.89 |
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 $316.23 Median $323.59 Typical High $354.81 | Professional | 52 · Reduced service | $316.23 | $323.59 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $128.82 Typical High $144.54 | Professional | 53 · Discontinued | $125.89 | $128.82 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $478.63 Typical High $537.03 | Professional | 54 · Surgery only | $478.63 | $478.63 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $95.50 Typical High $107.15 | Professional | 55 · Aftercare only | $95.50 | $95.50 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $64.57 Typical High $70.79 | Professional | 56 · Pre-op care only | $63.10 | $64.57 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $446.68 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $446.68 | $446.68 | $501.19 |
Where Georgia sits
The same service costs 7.2 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· 21st of 51
$891
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.