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 $1,288.25 Median $5,370.32 Typical High $8,317.64 | Facility | None | $1,288.25 | $5,370.32 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $2,137.96 | Professional | None | $1,288.25 | $1,288.25 | $2,137.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $691.83 Median $1,380.38 Typical High $7,244.36 | Facility | None | $691.83 | $1,380.38 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,023.29 Median $1,621.81 Typical High $2,454.71 | Professional | None | $1,023.29 | $1,621.81 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,737.80 Median $2,454.71 Typical High $3,630.78 | Professional | 50 · Both sides | $1,737.80 | $2,454.71 | $3,630.78 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $263.03 Typical High $407.38 | Professional | 80 · Assistant surgeon | $181.97 | $263.03 | $407.38 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $229.09 Typical High $338.84 | Professional | AS · PA/NP assist | $162.18 | $229.09 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $3,388.44 Typical High $4,365.16 | Facility | None | $741.31 | $3,388.44 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,698.24 Typical High $3,090.30 | Professional | None | $1,174.90 | $1,698.24 | $3,090.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,071.52 Median $1,318.26 Typical High $2,754.23 | Professional | None | $1,071.52 | $1,318.26 | $2,754.23 |
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 $1,122.02 Median $1,659.59 Typical High $3,388.44 | Professional | None | $1,122.02 | $1,659.59 | $3,388.44 |
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 $645.65 Median $645.65 Typical High $724.44 | Professional | 52 · Reduced service | $645.65 | $645.65 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $288.40 | Professional | 53 · Discontinued | $257.04 | $257.04 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $977.24 Typical High $1,071.52 | Professional | 54 · Surgery only | $977.24 | $977.24 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $213.80 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $144.54 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $1,000.00 |
Where Georgia sits
The same service costs 6.9 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· 27th of 51
$1,622
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.