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 $1,412.54 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,412.54 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,412.54 Typical High $3,388.44 | Professional | None | $1,348.96 | $1,412.54 | $3,388.44 |
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 $1,288.25 Median $1,778.28 Typical High $3,019.95 | Professional | None | $1,288.25 | $1,778.28 | $3,019.95 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $851.14 Median $1,348.96 Typical High $2,290.87 | Professional | 62 · Two surgeons | $851.14 | $1,348.96 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $346.74 Typical High $489.78 | Professional | 80 · Assistant surgeon | $208.93 | $346.74 | $489.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $281.84 Typical High $426.58 | Professional | AS · PA/NP assist | $186.21 | $281.84 | $426.58 |
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 $1,445.44 Median $2,454.71 Typical High $3,715.35 | Professional | None | $1,445.44 | $2,454.71 | $3,715.35 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,412.54 Median $1,548.82 Typical High $4,365.16 | Professional | None | $1,412.54 | $1,548.82 | $4,365.16 |
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 $1,288.25 Median $1,995.26 Typical High $4,168.69 | Professional | None | $1,288.25 | $1,995.26 | $4,168.69 |
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 $676.08 Median $691.83 Typical High $851.14 | Professional | 52 · Reduced service | $676.08 | $691.83 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $281.84 Typical High $338.84 | Professional | 53 · Discontinued | $269.15 | $281.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,047.13 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,023.29 | $1,047.13 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $208.93 Typical High $251.19 | Professional | 55 · Aftercare only | $204.17 | $208.93 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $141.25 Typical High $169.82 | Professional | 56 · Pre-op care only | $134.90 | $141.25 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $977.24 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $954.99 | $977.24 | $1,174.90 |
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· 31st of 51
$1,698
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.