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 $3,630.78 Median $5,370.32 Typical High $7,943.28 | Facility | None | $3,630.78 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $3,548.13 Median $3,630.78 Typical High $5,370.32 | Professional | None | $3,548.13 | $3,630.78 | $5,370.32 |
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 $3,019.95 Median $4,466.84 Typical High $7,244.36 | Professional | None | $3,019.95 | $4,466.84 | $7,244.36 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,089.30 Median $2,884.03 Typical High $4,677.35 | Professional | 62 · Two surgeons | $2,089.30 | $2,884.03 | $4,677.35 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $524.81 Median $776.25 Typical High $1,202.26 | Professional | 80 · Assistant surgeon | $524.81 | $776.25 | $1,202.26 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $457.09 Median $645.65 Typical High $1,047.13 | Professional | AS · PA/NP assist | $457.09 | $645.65 | $1,047.13 |
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 $3,715.35 Median $5,888.44 Typical High $9,549.93 | Professional | None | $3,715.35 | $5,888.44 | $9,549.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,630.78 Median $3,981.07 Typical High $7,943.28 | Professional | None | $3,630.78 | $3,981.07 | $7,943.28 |
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 $3,388.44 Median $5,128.61 Typical High $11,748.98 | Professional | None | $3,388.44 | $5,128.61 | $11,748.98 |
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 $1,778.28 Median $1,819.70 Typical High $2,187.76 | Professional | 52 · Reduced service | $1,778.28 | $1,819.70 | $2,187.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $707.95 Median $724.44 Typical High $870.96 | Professional | 53 · Discontinued | $707.95 | $724.44 | $870.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,630.27 Median $2,691.53 Typical High $3,311.31 | Professional | 54 · Surgery only | $2,630.27 | $2,691.53 | $3,311.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $524.81 Median $549.54 Typical High $660.69 | Professional | 55 · Aftercare only | $524.81 | $549.54 | $660.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $354.81 Median $363.08 Typical High $436.52 | Professional | 56 · Pre-op care only | $354.81 | $363.08 | $436.52 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,454.71 Median $2,511.89 Typical High $3,090.30 | Professional | 78 · Unplanned return to OR | $2,454.71 | $2,511.89 | $3,090.30 |
Where Georgia sits
The same service costs 6.3 times more in Alaska than in Arkansas. 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· 22nd of 51
$4,365
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.