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 $1,479.11 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,479.11 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,479.11 Typical High $2,398.83 | Professional | None | $1,445.44 | $1,479.11 | $2,398.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $691.83 Median $1,348.96 Typical High $7,244.36 | Facility | None | $691.83 | $1,348.96 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,230.27 Median $1,905.46 Typical High $3,090.30 | Professional | None | $1,230.27 | $1,905.46 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $870.96 Median $1,380.38 Typical High $1,949.84 | Professional | 62 · Two surgeons | $870.96 | $1,380.38 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $371.54 Typical High $512.86 | Professional | 80 · Assistant surgeon | $223.87 | $371.54 | $512.86 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $309.03 Typical High $436.52 | Professional | AS · PA/NP assist | $194.98 | $309.03 | $436.52 |
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 $1,513.56 Median $2,238.72 Typical High $4,466.84 | Professional | None | $1,513.56 | $2,238.72 | $4,466.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,380.38 Median $1,621.81 Typical High $3,019.95 | Professional | None | $1,380.38 | $1,621.81 | $3,019.95 |
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 $1,380.38 Median $2,238.72 Typical High $4,570.88 | Professional | None | $1,380.38 | $2,238.72 | $4,570.88 |
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 $724.44 Median $741.31 Typical High $891.25 | Professional | 52 · Reduced service | $724.44 | $741.31 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $295.12 Typical High $363.08 | Professional | 53 · Discontinued | $288.40 | $295.12 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,122.02 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,096.48 | $1,122.02 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $223.87 Typical High $269.15 | Professional | 55 · Aftercare only | $218.78 | $223.87 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $147.91 Typical High $181.97 | Professional | 56 · Pre-op care only | $144.54 | $147.91 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,047.13 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,047.13 | $1,258.93 |
Where Georgia sits
The same service costs 4.9 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
$1,820
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.