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 $457.09 Median $5,370.32 Typical High $7,943.28 | Facility | None | $457.09 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $457.09 Typical High $549.54 | Professional | None | $436.52 | $457.09 | $549.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $794.33 Median $1,513.56 Typical High $8,912.51 | Facility | None | $794.33 | $1,513.56 | $8,912.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $416.87 Median $588.84 Typical High $660.69 | Professional | None | $416.87 | $588.84 | $660.69 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $302.00 Median $371.54 Typical High $416.87 | Professional | 62 · Two surgeons | $302.00 | $371.54 | $416.87 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $77.62 Median $93.33 Typical High $107.15 | Professional | 80 · Assistant surgeon | $77.62 | $93.33 | $107.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $67.61 Median $81.28 Typical High $93.33 | Professional | AS · PA/NP assist | $67.61 | $81.28 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $549.54 Typical High $2,398.83 | Facility | None | $457.09 | $549.54 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $602.56 Typical High $1,258.93 | Professional | None | $446.68 | $602.56 | $1,258.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $489.78 Median $524.81 Typical High $20,417.38 | Professional | None | $489.78 | $524.81 | $20,417.38 |
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 $269.15 Median $489.78 Typical High $758.58 | Professional | None | $269.15 | $489.78 | $758.58 |
3 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 54 · Surgery only Typical Low $323.59 Median $346.74 Typical High $363.08 | Professional | 54 · Surgery only | $323.59 | $346.74 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $69.18 Typical High $74.13 | Professional | 55 · Aftercare only | $64.57 | $69.18 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $45.71 Typical High $48.98 | Professional | 56 · Pre-op care only | $43.65 | $45.71 | $48.98 |
Where Georgia sits
The same service costs 7.1 times more in Wisconsin than in New York. 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· 37th of 51
$589
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.