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 $1,318.26 Median $5,623.41 Typical High $10,000.00 | Facility | None | $1,318.26 | $5,623.41 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,737.80 | Professional | None | $1,318.26 | $1,318.26 | $1,737.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $691.83 Median $1,348.96 Typical High $7,244.36 | Facility | None | $691.83 | $1,348.96 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,000.00 Median $1,584.89 Typical High $2,511.89 | Professional | None | $1,000.00 | $1,584.89 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $724.44 Median $1,000.00 Typical High $1,584.89 | Professional | 62 · Two surgeons | $724.44 | $1,000.00 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $257.04 Typical High $426.58 | Professional | 80 · Assistant surgeon | $181.97 | $257.04 | $426.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $234.42 Typical High $371.54 | Professional | AS · PA/NP assist | $158.49 | $234.42 | $371.54 |
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 $1,202.26 Median $1,659.59 Typical High $3,162.28 | Professional | None | $1,202.26 | $1,659.59 | $3,162.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,122.02 Median $1,348.96 Typical High $2,238.72 | Professional | None | $1,122.02 | $1,348.96 | $2,238.72 |
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 $1,023.29 Median $1,548.82 Typical High $3,467.37 | Professional | None | $1,023.29 | $1,548.82 | $3,467.37 |
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 $660.69 Median $660.69 Typical High $741.31 | Professional | 52 · Reduced service | $660.69 | $660.69 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $295.12 | Professional | 53 · Discontinued | $263.03 | $263.03 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,000.00 Typical High $1,096.48 | Professional | 54 · Surgery only | $1,000.00 | $1,000.00 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $218.78 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $147.91 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $933.25 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $933.25 | $933.25 | $1,023.29 |
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· 25th of 51
$1,585
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.