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 $489.78 Median $5,370.32 Typical High $7,943.28 | Facility | None | $489.78 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $741.31 | Professional | None | $489.78 | $489.78 | $741.31 |
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 $309.03 Median $588.84 Typical High $912.01 | Professional | None | $309.03 | $588.84 | $912.01 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $234.42 Median $371.54 Typical High $575.44 | Professional | 62 · Two surgeons | $234.42 | $371.54 | $575.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $58.88 Median $93.33 Typical High $147.91 | Professional | 80 · Assistant surgeon | $58.88 | $93.33 | $147.91 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $51.29 Median $83.18 Typical High $128.82 | Professional | AS · PA/NP assist | $51.29 | $83.18 | $128.82 |
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 $380.19 Median $630.96 Typical High $1,174.90 | Professional | None | $380.19 | $630.96 | $1,174.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $389.05 Median $489.78 Typical High $954.99 | Professional | None | $389.05 | $489.78 | $954.99 |
Oscar Health Setting Professional Modifier None Typical Low $398.11 Median $741.31 Typical High $912.01 | Professional | None | $398.11 | $741.31 | $912.01 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,479.11 Typical High $5,011.87 | Facility | None | $851.14 | $1,479.11 | $5,011.87 |
United Setting Professional Modifier None Typical Low $288.40 Median $512.86 Typical High $1,288.25 | Professional | None | $288.40 | $512.86 | $1,288.25 |
5 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 $245.47 Median $245.47 Typical High $275.42 | Professional | 52 · Reduced service | $245.47 | $245.47 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $112.20 | Professional | 53 · Discontinued | $97.72 | $97.72 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $363.08 Typical High $416.87 | Professional | 54 · Surgery only | $363.08 | $363.08 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $83.18 | Professional | 55 · Aftercare only | $72.44 | $72.44 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $54.95 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $54.95 |
Where Georgia sits
The same service costs 5.2 times more in Alaska than in Kentucky. 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
$617
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.