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 $2,454.71 Median $5,370.32 Typical High $7,943.28 | Facility | None | $2,454.71 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $2,398.83 Median $2,454.71 Typical High $4,073.80 | Professional | None | $2,398.83 | $2,454.71 | $4,073.80 |
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 $1,905.46 Median $3,019.95 Typical High $4,786.30 | Professional | None | $1,905.46 | $3,019.95 | $4,786.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,348.96 Median $1,905.46 Typical High $3,090.30 | Professional | 62 · Two surgeons | $1,348.96 | $1,905.46 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $338.84 Median $478.63 Typical High $812.83 | Professional | 80 · Assistant surgeon | $338.84 | $478.63 | $812.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $302.00 Median $416.87 Typical High $691.83 | Professional | AS · PA/NP assist | $302.00 | $416.87 | $691.83 |
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 $2,511.89 Median $3,715.35 Typical High $6,456.54 | Professional | None | $2,511.89 | $3,715.35 | $6,456.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,454.71 Median $2,691.53 Typical High $5,128.61 | Professional | None | $2,454.71 | $2,691.53 | $5,128.61 |
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 $2,041.74 Median $3,235.94 Typical High $7,413.10 | Professional | None | $2,041.74 | $3,235.94 | $7,413.10 |
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 $1,202.26 Median $1,230.27 Typical High $1,479.11 | Professional | 52 · Reduced service | $1,202.26 | $1,230.27 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $489.78 Typical High $588.84 | Professional | 53 · Discontinued | $478.63 | $489.78 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $1,819.70 Typical High $2,238.72 | Professional | 54 · Surgery only | $1,778.28 | $1,819.70 | $2,238.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $371.54 Typical High $446.68 | Professional | 55 · Aftercare only | $354.81 | $371.54 | $446.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $245.47 Typical High $295.12 | Professional | 56 · Pre-op care only | $239.88 | $245.47 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $1,698.24 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $1,659.59 | $1,698.24 | $2,089.30 |
Where Georgia sits
The same service costs 5.2 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· 23rd of 51
$2,818
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.