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 $2,630.27 Median $5,370.32 Typical High $7,943.28 | Facility | None | $2,630.27 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $2,511.89 Median $2,630.27 Typical High $5,370.32 | Professional | None | $2,511.89 | $2,630.27 | $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 $2,187.76 Median $3,388.44 Typical High $5,370.32 | Professional | None | $2,187.76 | $3,388.44 | $5,370.32 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $389.05 Median $602.56 Typical High $891.25 | Professional | 80 · Assistant surgeon | $389.05 | $602.56 | $891.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $346.74 Median $501.19 Typical High $776.25 | Professional | AS · PA/NP assist | $346.74 | $501.19 | $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 $4,786.30 Typical High $6,760.83 | Professional | None | $2,691.53 | $4,786.30 | $6,760.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,511.89 Median $2,818.38 Typical High $8,511.38 | Professional | None | $2,511.89 | $2,818.38 | $8,511.38 |
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 $2,398.83 Median $3,801.89 Typical High $7,762.47 | Professional | None | $2,398.83 | $3,801.89 | $7,762.47 |
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 $1,258.93 Median $1,288.25 Typical High $1,584.89 | Professional | 52 · Reduced service | $1,258.93 | $1,288.25 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $501.19 Median $524.81 Typical High $630.96 | Professional | 53 · Discontinued | $501.19 | $524.81 | $630.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $1,949.84 Typical High $2,344.23 | Professional | 54 · Surgery only | $1,905.46 | $1,949.84 | $2,344.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $389.05 Typical High $467.74 | Professional | 55 · Aftercare only | $380.19 | $389.05 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $251.19 Median $263.03 Typical High $316.23 | Professional | 56 · Pre-op care only | $251.19 | $263.03 | $316.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $1,819.70 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $1,778.28 | $1,819.70 | $2,187.76 |
Where Georgia sits
The same service costs 6.9 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
$3,162
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.