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 $1,621.81 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,621.81 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,621.81 Typical High $2,951.21 | Professional | None | $1,548.82 | $1,621.81 | $2,951.21 |
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 $1,348.96 Median $1,995.26 Typical High $3,311.31 | Professional | None | $1,348.96 | $1,995.26 | $3,311.31 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $933.25 Median $1,380.38 Typical High $2,089.30 | Professional | 62 · Two surgeons | $933.25 | $1,380.38 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $234.42 Median $363.08 Typical High $549.54 | Professional | 80 · Assistant surgeon | $234.42 | $363.08 | $549.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $309.03 Typical High $478.63 | Professional | AS · PA/NP assist | $204.17 | $309.03 | $478.63 |
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 $1,659.59 Median $2,754.23 Typical High $4,168.69 | Professional | None | $1,659.59 | $2,754.23 | $4,168.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,621.81 Median $1,778.28 Typical High $3,801.89 | Professional | None | $1,621.81 | $1,778.28 | $3,801.89 |
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 $1,479.11 Median $2,238.72 Typical High $4,786.30 | Professional | None | $1,479.11 | $2,238.72 | $4,786.30 |
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 $776.25 Median $794.33 Typical High $977.24 | Professional | 52 · Reduced service | $776.25 | $794.33 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $323.59 Typical High $389.05 | Professional | 53 · Discontinued | $309.03 | $323.59 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,202.26 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,174.90 | $1,202.26 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $239.88 Typical High $288.40 | Professional | 55 · Aftercare only | $234.42 | $239.88 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $162.18 Typical High $194.98 | Professional | 56 · Pre-op care only | $154.88 | $162.18 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,122.02 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,122.02 | $1,348.96 |
Where Georgia sits
The same service costs 5.6 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· 28th of 51
$1,950
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.