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 $1,348.96 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,348.96 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,548.82 | Professional | None | $1,348.96 | $1,348.96 | $1,548.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $2,089.30 Typical High $12,022.64 | Facility | None | $1,047.13 | $2,089.30 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,174.90 Median $1,698.24 Typical High $2,691.53 | Professional | None | $1,174.90 | $1,698.24 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $794.33 Median $1,096.48 Typical High $1,737.80 | Professional | 62 · Two surgeons | $794.33 | $1,096.48 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $281.84 Typical High $436.52 | Professional | 80 · Assistant surgeon | $199.53 | $281.84 | $436.52 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $245.47 Typical High $380.19 | Professional | AS · PA/NP assist | $177.83 | $245.47 | $380.19 |
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 $1,412.54 Median $1,949.84 Typical High $3,235.94 | Professional | None | $1,412.54 | $1,949.84 | $3,235.94 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,230.27 Median $1,513.56 Typical High $2,630.27 | Professional | None | $1,230.27 | $1,513.56 | $2,630.27 |
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 $1,288.25 Median $1,819.70 Typical High $3,467.37 | Professional | None | $1,288.25 | $1,819.70 | $3,467.37 |
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 $676.08 Median $676.08 Typical High $776.25 | Professional | 52 · Reduced service | $676.08 | $676.08 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $309.03 | Professional | 53 · Discontinued | $269.15 | $269.15 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,000.00 Typical High $1,148.15 | Professional | 54 · Surgery only | $1,000.00 | $1,000.00 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $229.09 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $154.88 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $933.25 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $933.25 | $933.25 | $1,071.52 |
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· 21st of 51
$1,698
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.