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 $2,187.76 Median $5,370.32 Typical High $7,943.28 | Facility | None | $2,187.76 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $2,137.96 Median $2,187.76 Typical High $5,370.32 | Professional | None | $2,137.96 | $2,187.76 | $5,370.32 |
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 $2,041.74 Median $2,951.21 Typical High $4,570.88 | Professional | None | $2,041.74 | $2,951.21 | $4,570.88 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,318.26 Median $1,995.26 Typical High $2,884.03 | Professional | 62 · Two surgeons | $1,318.26 | $1,995.26 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $331.13 Median $549.54 Typical High $758.58 | Professional | 80 · Assistant surgeon | $331.13 | $549.54 | $758.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $288.40 Median $446.68 Typical High $645.65 | Professional | AS · PA/NP assist | $288.40 | $446.68 | $645.65 |
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 $2,290.87 Median $4,073.80 Typical High $5,754.40 | Professional | None | $2,290.87 | $4,073.80 | $5,754.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,187.76 Median $2,398.83 Typical High $7,244.36 | Professional | None | $2,187.76 | $2,398.83 | $7,244.36 |
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 $6,606.93 | Professional | None | $2,041.74 | $3,235.94 | $6,606.93 |
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 $1,071.52 Median $1,096.48 Typical High $1,318.26 | Professional | 52 · Reduced service | $1,071.52 | $1,096.48 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $436.52 Typical High $524.81 | Professional | 53 · Discontinued | $426.58 | $436.52 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,659.59 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,584.89 | $1,659.59 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $331.13 Typical High $398.11 | Professional | 55 · Aftercare only | $316.23 | $331.13 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $218.78 Typical High $263.03 | Professional | 56 · Pre-op care only | $213.80 | $218.78 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,548.82 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,548.82 | $1,862.09 |
Where Georgia sits
The same service costs 5.8 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· 25th of 51
$2,692
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.