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 $1,698.24 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,698.24 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $1,698.24 Typical High $4,265.80 | Professional | None | $1,659.59 | $1,698.24 | $4,265.80 |
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 $1,584.89 Median $2,238.72 Typical High $3,548.13 | Professional | None | $1,584.89 | $2,238.72 | $3,548.13 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,023.29 Median $1,548.82 Typical High $2,344.23 | Professional | 62 · Two surgeons | $1,023.29 | $1,548.82 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $257.04 Median $416.87 Typical High $588.84 | Professional | 80 · Assistant surgeon | $257.04 | $416.87 | $588.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $223.87 Median $338.84 Typical High $512.86 | Professional | AS · PA/NP assist | $223.87 | $338.84 | $512.86 |
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 $1,737.80 Median $3,019.95 Typical High $4,570.88 | Professional | None | $1,737.80 | $3,019.95 | $4,570.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,737.80 Median $1,905.46 Typical High $5,370.32 | Professional | None | $1,737.80 | $1,905.46 | $5,370.32 |
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 $1,584.89 Median $2,454.71 Typical High $5,128.61 | Professional | None | $1,584.89 | $2,454.71 | $5,128.61 |
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 $831.76 Median $851.14 Typical High $1,047.13 | Professional | 52 · Reduced service | $831.76 | $851.14 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $346.74 Typical High $416.87 | Professional | 53 · Discontinued | $331.13 | $346.74 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,288.25 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,258.93 | $1,288.25 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $257.04 Typical High $309.03 | Professional | 55 · Aftercare only | $251.19 | $257.04 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $169.82 Typical High $208.93 | Professional | 56 · Pre-op care only | $165.96 | $169.82 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,202.26 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,202.26 | $1,445.44 |
Where Georgia sits
The same service costs 5.6 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· 28th of 51
$2,089
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.