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 $1,584.89 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,584.89 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,584.89 Typical High $3,467.37 | Professional | None | $1,513.56 | $1,584.89 | $3,467.37 |
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 $1,445.44 Median $2,041.74 Typical High $3,235.94 | Professional | None | $1,445.44 | $2,041.74 | $3,235.94 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $933.25 Median $1,445.44 Typical High $2,137.96 | Professional | 62 · Two surgeons | $933.25 | $1,445.44 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $234.42 Median $389.05 Typical High $537.03 | Professional | 80 · Assistant surgeon | $234.42 | $389.05 | $537.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $302.00 Typical High $467.74 | Professional | AS · PA/NP assist | $204.17 | $302.00 | $467.74 |
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 $1,584.89 Median $2,884.03 Typical High $4,168.69 | Professional | None | $1,584.89 | $2,884.03 | $4,168.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,584.89 Median $1,737.80 Typical High $4,466.84 | Professional | None | $1,584.89 | $1,737.80 | $4,466.84 |
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 $1,445.44 Median $2,238.72 Typical High $4,677.35 | Professional | None | $1,445.44 | $2,238.72 | $4,677.35 |
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 $758.58 Median $776.25 Typical High $954.99 | Professional | 52 · Reduced service | $758.58 | $776.25 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $316.23 Typical High $380.19 | Professional | 53 · Discontinued | $302.00 | $316.23 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,174.90 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,148.15 | $1,174.90 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $234.42 Typical High $281.84 | Professional | 55 · Aftercare only | $229.09 | $234.42 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $158.49 Typical High $190.55 | Professional | 56 · Pre-op care only | $151.36 | $158.49 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,096.48 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,096.48 | $1,318.26 |
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· 31st of 51
$1,905
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.