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 $2,290.87 Median $5,370.32 Typical High $7,943.28 | Facility | None | $2,290.87 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $2,238.72 Median $2,290.87 Typical High $5,370.32 | Professional | None | $2,238.72 | $2,290.87 | $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 $2,137.96 Median $3,162.28 Typical High $4,897.79 | Professional | None | $2,137.96 | $3,162.28 | $4,897.79 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,380.38 Median $2,089.30 Typical High $3,090.30 | Professional | 62 · Two surgeons | $1,380.38 | $2,089.30 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $346.74 Median $575.44 Typical High $794.33 | Professional | 80 · Assistant surgeon | $346.74 | $575.44 | $794.33 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $302.00 Median $467.74 Typical High $691.83 | Professional | AS · PA/NP assist | $302.00 | $467.74 | $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 $2,398.83 Median $4,265.80 Typical High $6,025.60 | Professional | None | $2,398.83 | $4,265.80 | $6,025.60 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,290.87 Median $2,511.89 Typical High $7,079.46 | Professional | None | $2,290.87 | $2,511.89 | $7,079.46 |
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 $2,137.96 Median $3,388.44 Typical High $6,918.31 | Professional | None | $2,137.96 | $3,388.44 | $6,918.31 |
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 $1,122.02 Median $1,148.15 Typical High $1,380.38 | Professional | 52 · Reduced service | $1,122.02 | $1,148.15 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $457.09 Typical High $562.34 | Professional | 53 · Discontinued | $446.68 | $457.09 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $1,737.80 Typical High $2,089.30 | Professional | 54 · Surgery only | $1,698.24 | $1,737.80 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $346.74 Typical High $416.87 | Professional | 55 · Aftercare only | $338.84 | $346.74 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $229.09 Typical High $281.84 | Professional | 56 · Pre-op care only | $223.87 | $229.09 | $281.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,621.81 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,621.81 | $1,949.84 |
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· 28th 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.