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 $1,778.28 Median $7,079.46 Typical High $12,302.69 | Facility | None | $1,778.28 | $7,079.46 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $1,778.28 Median $1,819.70 Typical High $2,818.38 | Professional | None | $1,778.28 | $1,819.70 | $2,818.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,000.00 Median $1,862.09 Typical High $7,244.36 | Facility | None | $1,000.00 | $1,862.09 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,412.54 Median $2,238.72 Typical High $3,311.31 | Professional | None | $1,412.54 | $2,238.72 | $3,311.31 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,000.00 Median $1,412.54 Typical High $2,089.30 | Professional | 62 · Two surgeons | $1,000.00 | $1,412.54 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $1,513.56 Median $3,467.37 Typical High $4,677.35 | Facility | None | $1,513.56 | $3,467.37 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $2,398.83 Typical High $4,168.69 | Professional | None | $1,621.81 | $2,398.83 | $4,168.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,513.56 Median $1,819.70 Typical High $3,630.78 | Professional | None | $1,513.56 | $1,819.70 | $3,630.78 |
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 $1,479.11 Median $2,344.23 Typical High $4,570.88 | Professional | None | $1,479.11 | $2,344.23 | $4,570.88 |
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 $891.25 Median $891.25 Typical High $1,000.00 | Professional | 52 · Reduced service | $891.25 | $891.25 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $354.81 Typical High $398.11 | Professional | 53 · Discontinued | $354.81 | $354.81 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,348.96 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,348.96 | $1,348.96 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $269.15 Typical High $295.12 | Professional | 55 · Aftercare only | $269.15 | $269.15 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $177.83 Typical High $199.53 | Professional | 56 · Pre-op care only | $177.83 | $177.83 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,258.93 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,258.93 | $1,380.38 |
Where Georgia sits
The same service costs 6.3 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· 26th of 51
$2,239
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.