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 $831.76 Median $5,370.32 Typical High $7,943.28 | Facility | None | $831.76 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $831.76 Typical High $1,000.00 | Professional | None | $812.83 | $831.76 | $1,000.00 |
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 $691.83 Median $1,148.15 Typical High $1,698.24 | Professional | None | $691.83 | $1,148.15 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $181.97 Typical High $281.84 | Professional | 80 · Assistant surgeon | $125.89 | $181.97 | $281.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $109.65 Median $162.18 Typical High $239.88 | Professional | AS · PA/NP assist | $109.65 | $162.18 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $758.58 Typical High $4,265.80 | Facility | None | $501.19 | $758.58 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,513.56 Typical High $2,187.76 | Professional | None | $870.96 | $1,513.56 | $2,187.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $812.83 Median $891.25 Typical High $6,025.60 | Professional | None | $812.83 | $891.25 | $6,025.60 |
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 $776.25 Median $1,258.93 Typical High $2,511.89 | Professional | None | $776.25 | $1,258.93 | $2,511.89 |
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 $407.38 Median $416.87 Typical High $457.09 | Professional | 52 · Reduced service | $407.38 | $416.87 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $165.96 Typical High $181.97 | Professional | 53 · Discontinued | $162.18 | $165.96 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $630.96 Typical High $691.83 | Professional | 54 · Surgery only | $616.60 | $630.96 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $125.89 Typical High $138.04 | Professional | 55 · Aftercare only | $123.03 | $125.89 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $83.18 Typical High $91.20 | Professional | 56 · Pre-op care only | $81.28 | $83.18 | $91.20 |
Where Georgia sits
The same service costs 3.8 times more in Wisconsin 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· 16th of 51
$1,148
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.