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 $524.81 Median $5,370.32 Typical High $10,000.00 | Facility | None | $524.81 | $5,370.32 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $933.25 | Professional | None | $524.81 | $524.81 | $933.25 |
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 $467.74 Median $676.08 Typical High $1,047.13 | Professional | None | $467.74 | $676.08 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $79.43 Median $117.49 Typical High $173.78 | Professional | 80 · Assistant surgeon | $79.43 | $117.49 | $173.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $70.79 Median $100.00 Typical High $147.91 | Professional | AS · PA/NP assist | $70.79 | $100.00 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $5,623.41 Typical High $7,413.10 | Facility | None | $602.56 | $5,623.41 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $776.25 Typical High $1,258.93 | Professional | None | $562.34 | $776.25 | $1,258.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $467.74 Median $588.84 Typical High $1,202.26 | Professional | None | $467.74 | $588.84 | $1,202.26 |
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 $501.19 Median $741.31 Typical High $1,348.96 | Professional | None | $501.19 | $741.31 | $1,348.96 |
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 $257.04 Median $257.04 Typical High $302.00 | Professional | 52 · Reduced service | $257.04 | $257.04 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $104.71 Typical High $120.23 | Professional | 53 · Discontinued | $104.71 | $104.71 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $389.05 Typical High $446.68 | Professional | 54 · Surgery only | $389.05 | $389.05 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $89.13 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $52.48 Typical High $60.26 | Professional | 56 · Pre-op care only | $52.48 | $52.48 | $60.26 |
Where Georgia sits
The same service costs 3.9 times more in Alaska than in New York. 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
$776
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.