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 $2,137.96 Median $5,370.32 Typical High $7,943.28 | Facility | None | $2,137.96 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $2,041.74 Median $2,137.96 Typical High $5,011.87 | Professional | None | $2,041.74 | $2,137.96 | $5,011.87 |
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 $1,862.09 Median $2,754.23 Typical High $4,265.80 | Professional | None | $1,862.09 | $2,754.23 | $4,265.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,258.93 Median $1,862.09 Typical High $2,754.23 | Professional | 62 · Two surgeons | $1,258.93 | $1,862.09 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $316.23 Median $501.19 Typical High $724.44 | Professional | 80 · Assistant surgeon | $316.23 | $501.19 | $724.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $281.84 Median $416.87 Typical High $616.60 | Professional | AS · PA/NP assist | $281.84 | $416.87 | $616.60 |
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 $2,187.76 Median $3,890.45 Typical High $5,623.41 | Professional | None | $2,187.76 | $3,890.45 | $5,623.41 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,089.30 Median $2,290.87 Typical High $6,309.57 | Professional | None | $2,089.30 | $2,290.87 | $6,309.57 |
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 $1,949.84 Median $3,019.95 Typical High $6,456.54 | Professional | None | $1,949.84 | $3,019.95 | $6,456.54 |
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 $1,023.29 Median $1,071.52 Typical High $1,288.25 | Professional | 52 · Reduced service | $1,023.29 | $1,071.52 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $426.58 Typical High $512.86 | Professional | 53 · Discontinued | $416.87 | $426.58 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,584.89 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,548.82 | $1,584.89 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $316.23 Typical High $380.19 | Professional | 55 · Aftercare only | $309.03 | $316.23 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $213.80 Typical High $257.04 | Professional | 56 · Pre-op care only | $204.17 | $213.80 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $1,479.11 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,479.11 | $1,778.28 |
Where Georgia sits
The same service costs 6.0 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· 27th of 51
$2,570
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.