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 $1,288.25 Median $1,348.96 Typical High $3,090.30 | Professional | None | $1,288.25 | $1,348.96 | $3,090.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $912.01 Median $1,698.24 Typical High $9,772.37 | Facility | None | $912.01 | $1,698.24 | $9,772.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,230.27 Median $1,778.28 Typical High $2,884.03 | Professional | None | $1,230.27 | $1,778.28 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $812.83 Median $1,258.93 Typical High $1,819.70 | Professional | 62 · Two surgeons | $812.83 | $1,258.93 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $331.13 Typical High $467.74 | Professional | 80 · Assistant surgeon | $204.17 | $331.13 | $467.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $275.42 Typical High $407.38 | Professional | AS · PA/NP assist | $177.83 | $275.42 | $407.38 |
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 $1,348.96 Median $2,454.71 Typical High $3,548.13 | Professional | None | $1,348.96 | $2,454.71 | $3,548.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,348.96 Median $1,479.11 Typical High $3,890.45 | Professional | None | $1,348.96 | $1,479.11 | $3,890.45 |
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 $1,230.27 Median $1,905.46 Typical High $3,981.07 | Professional | None | $1,230.27 | $1,905.46 | $3,981.07 |
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 $645.65 Median $676.08 Typical High $812.83 | Professional | 52 · Reduced service | $645.65 | $676.08 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $269.15 Typical High $323.59 | Professional | 53 · Discontinued | $257.04 | $269.15 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,000.00 Typical High $1,202.26 | Professional | 54 · Surgery only | $977.24 | $1,000.00 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $199.53 Typical High $239.88 | Professional | 55 · Aftercare only | $194.98 | $199.53 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $134.90 Typical High $162.18 | Professional | 56 · Pre-op care only | $128.82 | $134.90 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $933.25 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $912.01 | $933.25 | $1,122.02 |
Where Georgia sits
The same service costs 5.5 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· 31st of 51
$1,622
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.