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 $891.25 Median $5,370.32 Typical High $7,943.28 | Facility | None | $891.25 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,023.29 | Professional | None | $891.25 | $891.25 | $1,023.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,819.70 Typical High $7,762.47 | Facility | None | $588.84 | $1,819.70 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $831.76 Median $1,122.02 Typical High $1,819.70 | Professional | None | $831.76 | $1,122.02 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $537.03 Median $724.44 Typical High $1,148.15 | Professional | 62 · Two surgeons | $537.03 | $724.44 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $134.90 Median $204.17 Typical High $309.03 | Professional | 80 · Assistant surgeon | $134.90 | $204.17 | $309.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $117.49 Median $173.78 Typical High $269.15 | Professional | AS · PA/NP assist | $117.49 | $173.78 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $549.54 Typical High $2,511.89 | Facility | None | $446.68 | $549.54 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,348.96 Typical High $2,137.96 | Professional | None | $891.25 | $1,348.96 | $2,137.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $831.76 Median $1,023.29 Typical High $2,454.71 | Professional | None | $831.76 | $1,023.29 | $2,454.71 |
United Setting Facility Modifier None Typical Low $371.54 Median $645.65 Typical High $3,981.07 | Facility | None | $371.54 | $645.65 | $3,981.07 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,202.26 Typical High $2,344.23 | Professional | None | $851.14 | $1,202.26 | $2,344.23 |
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 $446.68 Median $446.68 Typical High $512.86 | Professional | 52 · Reduced service | $446.68 | $446.68 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $204.17 | Professional | 53 · Discontinued | $177.83 | $177.83 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $758.58 | Professional | 54 · Surgery only | $660.69 | $660.69 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $151.36 | Professional | 55 · Aftercare only | $134.90 | $134.90 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $102.33 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $707.95 |
Where Georgia sits
The same service costs 6.2 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· 24th of 51
$1,122
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.