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 $1,230.27 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,230.27 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,412.54 | Professional | None | $1,230.27 | $1,230.27 | $1,412.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $794.33 Median $1,513.56 Typical High $8,912.51 | Facility | None | $794.33 | $1,513.56 | $8,912.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,023.29 Median $1,584.89 Typical High $2,398.83 | Professional | None | $1,023.29 | $1,584.89 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $741.31 Median $1,000.00 Typical High $1,584.89 | Professional | 62 · Two surgeons | $741.31 | $1,000.00 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $257.04 Typical High $407.38 | Professional | 80 · Assistant surgeon | $181.97 | $257.04 | $407.38 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $223.87 Typical High $354.81 | Professional | AS · PA/NP assist | $162.18 | $223.87 | $354.81 |
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 $1,288.25 Median $1,778.28 Typical High $3,019.95 | Professional | None | $1,288.25 | $1,778.28 | $3,019.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,148.15 Median $1,445.44 Typical High $2,137.96 | Professional | None | $1,148.15 | $1,445.44 | $2,137.96 |
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 $1,122.02 Median $1,621.81 Typical High $3,235.94 | Professional | None | $1,122.02 | $1,621.81 | $3,235.94 |
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 $616.60 Median $616.60 Typical High $707.95 | Professional | 52 · Reduced service | $616.60 | $616.60 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $245.47 Typical High $281.84 | Professional | 53 · Discontinued | $245.47 | $245.47 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $933.25 Typical High $1,071.52 | Professional | 54 · Surgery only | $933.25 | $933.25 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $213.80 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $141.25 | Professional | 56 · Pre-op care only | $123.03 | $123.03 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $870.96 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $870.96 | $870.96 | $1,000.00 |
Where Georgia sits
The same service costs 6.8 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· 17th 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.