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 $2,238.72 Median $5,370.32 Typical High $7,943.28 | Facility | None | $2,238.72 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $2,187.76 Median $2,238.72 Typical High $5,128.61 | Professional | None | $2,187.76 | $2,238.72 | $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 $1,995.26 Median $2,951.21 Typical High $4,570.88 | Professional | None | $1,995.26 | $2,951.21 | $4,570.88 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,348.96 Median $2,041.74 Typical High $2,951.21 | Professional | 62 · Two surgeons | $1,348.96 | $2,041.74 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $338.84 Median $549.54 Typical High $776.25 | Professional | 80 · Assistant surgeon | $338.84 | $549.54 | $776.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $295.12 Median $457.09 Typical High $660.69 | Professional | AS · PA/NP assist | $295.12 | $457.09 | $660.69 |
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 $6,025.60 | Professional | None | $2,290.87 | $4,073.80 | $6,025.60 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,238.72 Median $2,454.71 Typical High $6,606.93 | Professional | None | $2,238.72 | $2,454.71 | $6,606.93 |
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 $2,089.30 Median $3,162.28 Typical High $6,760.83 | Professional | None | $2,089.30 | $3,162.28 | $6,760.83 |
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 $1,096.48 Median $1,122.02 Typical High $1,348.96 | Professional | 52 · Reduced service | $1,096.48 | $1,122.02 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $446.68 Typical High $549.54 | Professional | 53 · Discontinued | $436.52 | $446.68 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $1,698.24 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,659.59 | $1,698.24 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $338.84 Typical High $407.38 | Professional | 55 · Aftercare only | $331.13 | $338.84 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $223.87 Typical High $275.42 | Professional | 56 · Pre-op care only | $218.78 | $223.87 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,584.89 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,584.89 | $1,905.46 |
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· 24th of 51
$2,754
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.