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 $2,089.30 Median $5,370.32 Typical High $7,943.28 | Facility | None | $2,089.30 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,995.26 Median $2,089.30 Typical High $2,511.89 | Professional | None | $1,995.26 | $2,089.30 | $2,511.89 |
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 $1,905.46 Median $2,754.23 Typical High $3,090.30 | Professional | None | $1,905.46 | $2,754.23 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $371.54 Median $446.68 Typical High $489.78 | Professional | 80 · Assistant surgeon | $371.54 | $446.68 | $489.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $323.59 Median $389.05 Typical High $426.58 | Professional | AS · PA/NP assist | $323.59 | $389.05 | $426.58 |
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 $2,041.74 Median $2,884.03 Typical High $6,606.93 | Professional | None | $2,041.74 | $2,884.03 | $6,606.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,137.96 Median $2,344.23 Typical High $17,378.01 | Professional | None | $2,137.96 | $2,344.23 | $17,378.01 |
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 $1,584.89 Median $2,691.53 Typical High $4,466.84 | Professional | None | $1,584.89 | $2,691.53 | $4,466.84 |
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 $1,000.00 Median $1,047.13 Typical High $1,122.02 | Professional | 52 · Reduced service | $1,000.00 | $1,047.13 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $416.87 Typical High $446.68 | Professional | 53 · Discontinued | $398.11 | $416.87 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,584.89 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,479.11 | $1,584.89 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $316.23 Typical High $338.84 | Professional | 55 · Aftercare only | $295.12 | $316.23 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $208.93 Typical High $223.87 | Professional | 56 · Pre-op care only | $199.53 | $208.93 | $223.87 |
Where Georgia sits
The same service costs 4.7 times more in Alaska than in South Carolina. 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· 21st of 51
$2,630
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.