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 $831.76 Median $5,370.32 Typical High $7,943.28 | Facility | None | $831.76 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $831.76 Typical High $1,000.00 | Professional | None | $776.25 | $831.76 | $1,000.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $1,148.15 Typical High $5,754.40 | Facility | None | $575.44 | $1,148.15 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $616.60 Median $1,000.00 Typical High $1,621.81 | Professional | None | $616.60 | $1,000.00 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $158.49 Typical High $263.03 | Professional | 80 · Assistant surgeon | $107.15 | $158.49 | $263.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $95.50 Median $141.25 Typical High $223.87 | Professional | AS · PA/NP assist | $95.50 | $141.25 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,949.84 Typical High $2,691.53 | Facility | None | $602.56 | $1,949.84 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $1,023.29 Typical High $2,290.87 | Professional | None | $758.58 | $1,023.29 | $2,290.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $870.96 Median $977.24 Typical High $1,348.96 | Professional | None | $870.96 | $977.24 | $1,348.96 |
Oscar Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,258.93 | $1,479.11 | $1,479.11 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $7,585.78 | Facility | None | $954.99 | $1,995.26 | $7,585.78 |
United Setting Professional Modifier None Typical Low $602.56 Median $933.25 Typical High $2,511.89 | Professional | None | $602.56 | $933.25 | $2,511.89 |
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 $389.05 Median $407.38 Typical High $501.19 | Professional | 52 · Reduced service | $389.05 | $407.38 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $165.96 Typical High $199.53 | Professional | 53 · Discontinued | $154.88 | $165.96 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $616.60 Typical High $741.31 | Professional | 54 · Surgery only | $588.84 | $616.60 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $123.03 Typical High $151.36 | Professional | 55 · Aftercare only | $117.49 | $123.03 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $83.18 Typical High $100.00 | Professional | 56 · Pre-op care only | $77.62 | $83.18 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $575.44 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $549.54 | $575.44 | $691.83 |
Where Georgia sits
The same service costs 6.8 times more in Oklahoma 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· 32nd of 51
$1,047
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.