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 $5,623.41 Typical High $14,454.40 | Facility | None | $891.25 | $5,623.41 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $891.25 Typical High $1,778.28 | Professional | None | $851.14 | $891.25 | $1,778.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $1,148.15 Typical High $5,754.40 | Facility | None | $575.44 | $1,148.15 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $776.25 Median $1,096.48 Typical High $1,778.28 | Professional | None | $776.25 | $1,096.48 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $512.86 Median $831.76 Typical High $1,148.15 | Professional | 62 · Two surgeons | $512.86 | $831.76 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $128.82 Median $218.78 Typical High $295.12 | Professional | 80 · Assistant surgeon | $128.82 | $218.78 | $295.12 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $173.78 Typical High $257.04 | Professional | AS · PA/NP assist | $114.82 | $173.78 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $549.54 Typical High $2,691.53 | Facility | None | $457.09 | $549.54 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,621.81 Typical High $2,344.23 | Professional | None | $891.25 | $1,621.81 | $2,344.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $933.25 Median $1,000.00 Typical High $2,290.87 | Professional | None | $933.25 | $1,000.00 | $2,290.87 |
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 $812.83 Median $1,258.93 Typical High $2,630.27 | Professional | None | $812.83 | $1,258.93 | $2,630.27 |
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 $426.58 Median $446.68 Typical High $537.03 | Professional | 52 · Reduced service | $426.58 | $446.68 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $177.83 Typical High $213.80 | Professional | 53 · Discontinued | $169.82 | $177.83 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $660.69 Typical High $794.33 | Professional | 54 · Surgery only | $630.96 | $660.69 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $131.83 Typical High $158.49 | Professional | 55 · Aftercare only | $128.82 | $131.83 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $89.13 Typical High $107.15 | Professional | 56 · Pre-op care only | $85.11 | $89.13 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $616.60 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $588.84 | $616.60 | $741.31 |
Where Georgia sits
The same service costs 4.6 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· 33rd of 51
$1,072
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.