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 $1,905.46 Median $5,011.87 Typical High $7,943.28 | Facility | None | $1,905.46 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $2,344.23 | Professional | None | $1,949.84 | $1,949.84 | $2,344.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $512.86 Median $1,174.90 Typical High $7,244.36 | Facility | None | $512.86 | $1,174.90 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,513.56 Median $2,398.83 Typical High $3,630.78 | Professional | None | $1,513.56 | $2,398.83 | $3,630.78 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,071.52 Median $1,513.56 Typical High $2,344.23 | Professional | 62 · Two surgeons | $1,071.52 | $1,513.56 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $269.15 Median $380.19 Typical High $645.65 | Professional | 80 · Assistant surgeon | $269.15 | $380.19 | $645.65 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $239.88 Median $338.84 Typical High $524.81 | Professional | AS · PA/NP assist | $239.88 | $338.84 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $3,388.44 Typical High $4,265.80 | Facility | None | $524.81 | $3,388.44 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $1,819.70 Median $2,570.40 Typical High $4,570.88 | Professional | None | $1,819.70 | $2,570.40 | $4,570.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,621.81 Median $1,949.84 Typical High $3,019.95 | Professional | None | $1,621.81 | $1,949.84 | $3,019.95 |
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 $1,659.59 Median $2,511.89 Typical High $4,897.79 | Professional | None | $1,659.59 | $2,511.89 | $4,897.79 |
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 $977.24 Median $977.24 Typical High $1,071.52 | Professional | 52 · Reduced service | $977.24 | $977.24 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $389.05 Typical High $426.58 | Professional | 53 · Discontinued | $389.05 | $389.05 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,445.44 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,445.44 | $1,445.44 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $288.40 Typical High $316.23 | Professional | 55 · Aftercare only | $288.40 | $288.40 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $194.98 Typical High $213.80 | Professional | 56 · Pre-op care only | $194.98 | $194.98 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,348.96 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,348.96 | $1,479.11 |
Where Georgia sits
The same service costs 7.1 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· 23rd of 51
$2,399
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.