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 $2,691.53 Median $5,370.32 Typical High $7,943.28 | Facility | None | $2,691.53 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $2,570.40 Median $2,691.53 Typical High $5,370.32 | Professional | None | $2,570.40 | $2,691.53 | $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 $2,290.87 Median $3,548.13 Typical High $5,495.41 | Professional | None | $2,290.87 | $3,548.13 | $5,495.41 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,584.89 Median $2,454.71 Typical High $3,548.13 | Professional | 62 · Two surgeons | $1,584.89 | $2,454.71 | $3,548.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $407.38 Median $660.69 Typical High $912.01 | Professional | 80 · Assistant surgeon | $407.38 | $660.69 | $912.01 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $354.81 Median $537.03 Typical High $776.25 | Professional | AS · PA/NP assist | $354.81 | $537.03 | $776.25 |
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 $2,691.53 Median $4,897.79 Typical High $7,079.46 | Professional | None | $2,691.53 | $4,897.79 | $7,079.46 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,630.27 Median $2,884.03 Typical High $9,332.54 | Professional | None | $2,630.27 | $2,884.03 | $9,332.54 |
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 $2,454.71 Median $3,801.89 Typical High $8,128.31 | Professional | None | $2,454.71 | $3,801.89 | $8,128.31 |
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 $1,288.25 Median $1,318.26 Typical High $1,621.81 | Professional | 52 · Reduced service | $1,288.25 | $1,318.26 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $537.03 Typical High $645.65 | Professional | 53 · Discontinued | $512.86 | $537.03 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $1,995.26 Typical High $2,398.83 | Professional | 54 · Surgery only | $1,949.84 | $1,995.26 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $398.11 Typical High $478.63 | Professional | 55 · Aftercare only | $389.05 | $398.11 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $269.15 Typical High $323.59 | Professional | 56 · Pre-op care only | $257.04 | $269.15 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $1,862.09 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $1,819.70 | $1,862.09 | $2,238.72 |
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· 26th of 51
$3,236
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.