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 $2,398.83 Median $5,370.32 Typical High $7,943.28 | Facility | None | $2,398.83 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $2,290.87 Median $2,398.83 Typical High $5,370.32 | Professional | None | $2,290.87 | $2,398.83 | $5,370.32 |
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 $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 $1,412.54 Median $2,187.76 Typical High $3,090.30 | Professional | 62 · Two surgeons | $1,412.54 | $2,187.76 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $363.08 Median $588.84 Typical High $812.83 | Professional | 80 · Assistant surgeon | $363.08 | $588.84 | $812.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $316.23 Median $478.63 Typical High $691.83 | Professional | AS · PA/NP assist | $316.23 | $478.63 | $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 $2,454.71 Median $4,365.16 Typical High $6,309.57 | Professional | None | $2,454.71 | $4,365.16 | $6,309.57 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,344.23 Median $2,570.40 Typical High $7,244.36 | Professional | None | $2,344.23 | $2,570.40 | $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 $2,187.76 Median $3,467.37 Typical High $7,244.36 | Professional | None | $2,187.76 | $3,467.37 | $7,244.36 |
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 $1,148.15 Median $1,202.26 Typical High $1,445.44 | Professional | 52 · Reduced service | $1,148.15 | $1,202.26 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $478.63 Typical High $575.44 | Professional | 53 · Discontinued | $467.74 | $478.63 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $1,778.28 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,737.80 | $1,778.28 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $354.81 Typical High $426.58 | Professional | 55 · Aftercare only | $346.74 | $354.81 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $239.88 Typical High $288.40 | Professional | 56 · Pre-op care only | $229.09 | $239.88 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,659.59 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,659.59 | $1,995.26 |
Where Georgia sits
The same service costs 5.4 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· 26th of 51
$2,884
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.