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 $3,715.35 Median $5,370.32 Typical High $7,943.28 | Facility | None | $3,715.35 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $3,630.78 Median $3,715.35 Typical High $4,570.88 | Professional | None | $3,630.78 | $3,715.35 | $4,570.88 |
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 $3,235.94 Median $4,677.35 Typical High $8,128.31 | Professional | None | $3,235.94 | $4,677.35 | $8,128.31 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $575.44 Median $851.14 Typical High $1,318.26 | Professional | 80 · Assistant surgeon | $575.44 | $851.14 | $1,318.26 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $501.19 Median $707.95 Typical High $1,148.15 | Professional | AS · PA/NP assist | $501.19 | $707.95 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $549.54 Typical High $2,398.83 | Facility | None | $457.09 | $549.54 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $3,981.07 Median $6,456.54 Typical High $10,000.00 | Professional | None | $3,981.07 | $6,456.54 | $10,000.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,801.89 Median $4,168.69 Typical High $31,622.78 | Professional | None | $3,801.89 | $4,168.69 | $31,622.78 |
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 $3,548.13 Median $5,754.40 Typical High $11,481.54 | Professional | None | $3,548.13 | $5,754.40 | $11,481.54 |
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 $1,819.70 Median $1,862.09 Typical High $2,041.74 | Professional | 52 · Reduced service | $1,819.70 | $1,862.09 | $2,041.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $724.44 Median $741.31 Typical High $812.83 | Professional | 53 · Discontinued | $724.44 | $741.31 | $812.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,691.53 Median $2,818.38 Typical High $3,090.30 | Professional | 54 · Surgery only | $2,691.53 | $2,818.38 | $3,090.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $549.54 Median $562.34 Typical High $616.60 | Professional | 55 · Aftercare only | $549.54 | $562.34 | $616.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $363.08 Median $371.54 Typical High $407.38 | Professional | 56 · Pre-op care only | $363.08 | $371.54 | $407.38 |
Where Georgia sits
The same service costs 7.4 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· 28th 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.