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 $537.03 Median $5,370.32 Typical High $7,943.28 | Facility | None | $537.03 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $537.03 Typical High $645.65 | Professional | None | $524.81 | $537.03 | $645.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $512.86 Median $1,000.00 Typical High $4,570.88 | Facility | None | $512.86 | $1,000.00 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $436.52 Median $707.95 Typical High $1,047.13 | Professional | None | $436.52 | $707.95 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $79.43 Median $128.82 Typical High $181.97 | Professional | 80 · Assistant surgeon | $79.43 | $128.82 | $181.97 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $70.79 Median $102.33 Typical High $151.36 | Professional | AS · PA/NP assist | $70.79 | $102.33 | $151.36 |
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 $549.54 Median $912.01 Typical High $1,380.38 | Professional | None | $549.54 | $912.01 | $1,380.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $512.86 Median $575.44 Typical High $4,570.88 | Professional | None | $512.86 | $575.44 | $4,570.88 |
Oscar Health Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
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 $489.78 Median $812.83 Typical High $1,584.89 | Professional | None | $489.78 | $812.83 | $1,584.89 |
5 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 $257.04 Median $263.03 Typical High $295.12 | Professional | 52 · Reduced service | $257.04 | $263.03 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $107.15 Typical High $117.49 | Professional | 53 · Discontinued | $104.71 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $398.11 Typical High $436.52 | Professional | 54 · Surgery only | $389.05 | $398.11 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $79.43 Typical High $87.10 | Professional | 55 · Aftercare only | $77.62 | $79.43 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $53.70 Typical High $58.88 | Professional | 56 · Pre-op care only | $52.48 | $53.70 | $58.88 |
Where Georgia sits
The same service costs 4.0 times more in Wisconsin than in Kentucky. 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· 25th of 51
$708
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.