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 $1,949.84 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,949.84 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,905.46 Median $1,949.84 Typical High $5,128.61 | Professional | None | $1,905.46 | $1,949.84 | $5,128.61 |
Anthem BCBS Setting Facility Modifier None Typical Low $912.01 Median $1,698.24 Typical High $9,772.37 | Facility | None | $912.01 | $1,698.24 | $9,772.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,698.24 Median $2,398.83 Typical High $3,890.45 | Professional | None | $1,698.24 | $2,398.83 | $3,890.45 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,148.15 Median $1,659.59 Typical High $2,511.89 | Professional | 62 · Two surgeons | $1,148.15 | $1,659.59 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $288.40 Median $436.52 Typical High $660.69 | Professional | 80 · Assistant surgeon | $288.40 | $436.52 | $660.69 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $251.19 Median $371.54 Typical High $562.34 | Professional | AS · PA/NP assist | $251.19 | $371.54 | $562.34 |
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 $1,995.26 Median $3,311.31 Typical High $5,128.61 | Professional | None | $1,995.26 | $3,311.31 | $5,128.61 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,949.84 Median $2,137.96 Typical High $5,128.61 | Professional | None | $1,949.84 | $2,137.96 | $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 $1,737.80 Median $2,570.40 Typical High $5,888.44 | Professional | None | $1,737.80 | $2,570.40 | $5,888.44 |
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 $954.99 Median $977.24 Typical High $1,174.90 | Professional | 52 · Reduced service | $954.99 | $977.24 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $389.05 Typical High $467.74 | Professional | 53 · Discontinued | $380.19 | $389.05 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,445.44 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,412.54 | $1,445.44 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $295.12 Typical High $354.81 | Professional | 55 · Aftercare only | $281.84 | $295.12 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $194.98 Typical High $234.42 | Professional | 56 · Pre-op care only | $190.55 | $194.98 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,348.96 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,348.96 | $1,659.59 |
Where Georgia sits
The same service costs 5.9 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· 24th of 51
$2,399
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.