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 $1,412.54 Median $5,623.41 Typical High $9,549.93 | Facility | None | $1,412.54 | $5,623.41 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,445.44 Typical High $3,235.94 | Professional | None | $1,412.54 | $1,445.44 | $3,235.94 |
Anthem BCBS Setting Facility Modifier None Typical Low $776.25 Median $1,479.11 Typical High $7,244.36 | Facility | None | $776.25 | $1,479.11 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,778.28 Typical High $2,630.27 | Professional | None | $1,122.02 | $1,778.28 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $794.33 Median $1,122.02 Typical High $1,659.59 | Professional | 62 · Two surgeons | $794.33 | $1,122.02 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $281.84 Typical High $446.68 | Professional | 80 · Assistant surgeon | $204.17 | $281.84 | $446.68 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $251.19 Typical High $371.54 | Professional | AS · PA/NP assist | $177.83 | $251.19 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $3,467.37 Typical High $4,365.16 | Facility | None | $812.83 | $3,467.37 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,862.09 Typical High $3,388.44 | Professional | None | $1,318.26 | $1,862.09 | $3,388.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,202.26 Median $1,445.44 Typical High $2,818.38 | Professional | None | $1,202.26 | $1,445.44 | $2,818.38 |
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 $1,202.26 Median $1,819.70 Typical High $3,630.78 | Professional | None | $1,202.26 | $1,819.70 | $3,630.78 |
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 $707.95 Median $707.95 Typical High $776.25 | Professional | 52 · Reduced service | $707.95 | $707.95 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $316.23 | Professional | 53 · Discontinued | $281.84 | $281.84 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,071.52 Typical High $1,174.90 | Professional | 54 · Surgery only | $1,071.52 | $1,071.52 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $213.80 Typical High $234.42 | Professional | 55 · Aftercare only | $213.80 | $213.80 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $158.49 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,000.00 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,000.00 | $1,096.48 |
Where Georgia sits
The same service costs 6.6 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· 29th of 51
$1,778
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.