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 $1,548.82 Median $5,623.41 Typical High $10,000.00 | Facility | None | $1,548.82 | $5,623.41 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $2,398.83 | Professional | None | $1,548.82 | $1,548.82 | $2,398.83 |
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 $1,230.27 Median $1,949.84 Typical High $3,090.30 | Professional | None | $1,230.27 | $1,949.84 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $891.25 Median $1,258.93 Typical High $1,995.26 | Professional | 62 · Two surgeons | $891.25 | $1,258.93 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $338.84 Typical High $524.81 | Professional | 80 · Assistant surgeon | $223.87 | $338.84 | $524.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $275.42 Typical High $446.68 | Professional | AS · PA/NP assist | $194.98 | $275.42 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,467.37 Typical High $4,365.16 | Facility | None | $602.56 | $3,467.37 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $2,238.72 Typical High $3,715.35 | Professional | None | $1,513.56 | $2,238.72 | $3,715.35 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,288.25 Median $1,584.89 Typical High $3,090.30 | Professional | None | $1,288.25 | $1,584.89 | $3,090.30 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $7,585.78 | Facility | None | $954.99 | $1,995.26 | $7,585.78 |
United Setting Professional Modifier None Typical Low $1,412.54 Median $2,187.76 Typical High $3,981.07 | Professional | None | $1,412.54 | $2,187.76 | $3,981.07 |
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 $776.25 Median $776.25 Typical High $870.96 | Professional | 52 · Reduced service | $776.25 | $776.25 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $316.23 Typical High $346.74 | Professional | 53 · Discontinued | $316.23 | $316.23 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,174.90 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,174.90 | $1,174.90 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $234.42 Typical High $263.03 | Professional | 55 · Aftercare only | $234.42 | $234.42 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $154.88 Typical High $173.78 | Professional | 56 · Pre-op care only | $154.88 | $154.88 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,096.48 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,096.48 | $1,230.27 |
Where Georgia sits
The same service costs 6.5 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· 28th of 51
$1,950
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.