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 $2,754.23 Median $5,370.32 Typical High $7,943.28 | Facility | None | $2,754.23 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $2,691.53 Median $2,754.23 Typical High $5,128.61 | Professional | None | $2,691.53 | $2,754.23 | $5,128.61 |
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 $2,290.87 Median $3,388.44 Typical High $5,370.32 | Professional | None | $2,290.87 | $3,388.44 | $5,370.32 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,513.56 Median $2,137.96 Typical High $3,467.37 | Professional | 62 · Two surgeons | $1,513.56 | $2,137.96 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $389.05 Median $549.54 Typical High $912.01 | Professional | 80 · Assistant surgeon | $389.05 | $549.54 | $912.01 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $338.84 Median $478.63 Typical High $776.25 | Professional | AS · PA/NP assist | $338.84 | $478.63 | $776.25 |
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 $2,818.38 Median $3,890.45 Typical High $7,244.36 | Professional | None | $2,818.38 | $3,890.45 | $7,244.36 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,691.53 Median $2,951.21 Typical High $6,606.93 | Professional | None | $2,691.53 | $2,951.21 | $6,606.93 |
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 $2,238.72 Median $3,548.13 Typical High $8,317.64 | Professional | None | $2,238.72 | $3,548.13 | $8,317.64 |
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 $1,348.96 Median $1,380.38 Typical High $1,659.59 | Professional | 52 · Reduced service | $1,348.96 | $1,380.38 | $1,659.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $537.03 Median $549.54 Typical High $660.69 | Professional | 53 · Discontinued | $537.03 | $549.54 | $660.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,995.26 Median $2,089.30 Typical High $2,511.89 | Professional | 54 · Surgery only | $1,995.26 | $2,089.30 | $2,511.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $398.11 Median $416.87 Typical High $501.19 | Professional | 55 · Aftercare only | $398.11 | $416.87 | $501.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $269.15 Median $275.42 Typical High $331.13 | Professional | 56 · Pre-op care only | $269.15 | $275.42 | $331.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,862.09 Median $1,949.84 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $1,862.09 | $1,949.84 | $2,344.23 |
Where Georgia sits
The same service costs 6.3 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· 19th of 51
$3,236
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.