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 $436.52 Median $7,413.10 Typical High $12,302.69 | Facility | None | $436.52 | $7,413.10 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $5,370.32 | Professional | None | $436.52 | $436.52 | $5,370.32 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,862.09 Typical High $8,128.31 | Facility | None | $588.84 | $1,862.09 | $8,128.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $426.58 Median $707.95 Typical High $1,288.25 | Professional | None | $426.58 | $707.95 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $758.58 Median $1,071.52 Typical High $1,905.46 | Professional | 50 · Both sides | $758.58 | $1,071.52 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $323.59 Median $446.68 Typical High $812.83 | Professional | 62 · Two surgeons | $323.59 | $446.68 | $812.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $79.43 Median $112.20 Typical High $204.17 | Professional | 80 · Assistant surgeon | $79.43 | $112.20 | $204.17 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $70.79 Median $100.00 Typical High $177.83 | Professional | AS · PA/NP assist | $70.79 | $100.00 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $831.76 Typical High $4,265.80 | Facility | None | $512.86 | $831.76 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $933.25 Typical High $1,380.38 | Professional | None | $467.74 | $933.25 | $1,380.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $407.38 Median $478.63 Typical High $2,290.87 | Professional | None | $407.38 | $478.63 | $2,290.87 |
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 $436.52 Median $870.96 Typical High $1,348.96 | Professional | None | $436.52 | $870.96 | $1,348.96 |
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 $213.80 Median $218.78 Typical High $263.03 | Professional | 52 · Reduced service | $213.80 | $218.78 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $87.10 Typical High $107.15 | Professional | 53 · Discontinued | $87.10 | $87.10 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $331.13 Typical High $398.11 | Professional | 54 · Surgery only | $323.59 | $331.13 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $66.07 Typical High $79.43 | Professional | 55 · Aftercare only | $64.57 | $66.07 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $43.65 Typical High $53.70 | Professional | 56 · Pre-op care only | $43.65 | $43.65 | $53.70 |
Where Georgia sits
The same service costs 3.7 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· 26th of 51
$724
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.