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 $1,380.38 Median $5,623.41 Typical High $10,000.00 | Facility | None | $1,380.38 | $5,623.41 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,380.38 Typical High $3,630.78 | Professional | None | $1,348.96 | $1,380.38 | $3,630.78 |
Ambetter Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Professional | None | $2,691.53 | $2,691.53 | $2,691.53 |
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 $1,288.25 Median $1,995.26 Typical High $2,884.03 | Professional | None | $1,288.25 | $1,995.26 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,995.26 Median $3,090.30 Typical High $4,365.16 | Professional | 50 · Both sides | $1,995.26 | $3,090.30 | $4,365.16 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $851.14 Median $1,318.26 Typical High $1,862.09 | Professional | 62 · Two surgeons | $851.14 | $1,318.26 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $346.74 Typical High $478.63 | Professional | 80 · Assistant surgeon | $208.93 | $346.74 | $478.63 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $281.84 Typical High $407.38 | Professional | AS · PA/NP assist | $186.21 | $281.84 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $1,479.11 Median $3,715.35 Typical High $5,011.87 | Facility | None | $1,479.11 | $3,715.35 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $2,630.27 Typical High $4,168.69 | Professional | None | $1,445.44 | $2,630.27 | $4,168.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,288.25 Median $1,513.56 Typical High $4,265.80 | Professional | None | $1,288.25 | $1,513.56 | $4,265.80 |
Oscar Health Setting Professional Modifier None Typical Low $2,187.76 Median $2,398.83 Typical High $2,398.83 | Professional | None | $2,187.76 | $2,398.83 | $2,398.83 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $3,715.35 Typical High $9,549.93 | Facility | None | $1,513.56 | $3,715.35 | $9,549.93 |
United Setting Professional Modifier None Typical Low $1,288.25 Median $2,089.30 Typical High $4,265.80 | Professional | None | $1,288.25 | $2,089.30 | $4,265.80 |
2 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 $1,023.29 Median $1,047.13 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,023.29 | $1,047.13 | $1,258.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $977.24 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $954.99 | $977.24 | $1,174.90 |
Where Georgia sits
The same service costs 5.4 times more in Wisconsin 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· 23rd of 51
$2,138
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.