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 $977.24 Median $5,370.32 Typical High $7,943.28 | Facility | None | $977.24 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $645.65 Typical High $3,801.89 | Professional | None | $630.96 | $645.65 | $3,801.89 |
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 $602.56 Median $912.01 Typical High $1,445.44 | Professional | None | $602.56 | $912.01 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $933.25 Median $1,513.56 Typical High $2,238.72 | Professional | 50 · Both sides | $933.25 | $1,513.56 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $389.05 Median $630.96 Typical High $954.99 | Professional | 62 · Two surgeons | $389.05 | $630.96 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,862.09 Typical High $2,454.71 | Facility | None | $602.56 | $1,862.09 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $1,258.93 Typical High $1,778.28 | Professional | None | $676.08 | $1,258.93 | $1,778.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $616.60 Median $660.69 Typical High $2,187.76 | Professional | None | $616.60 | $660.69 | $2,187.76 |
Oscar Health Setting Professional Modifier None Typical Low $954.99 Median $1,096.48 Typical High $1,122.02 | Professional | None | $954.99 | $1,096.48 | $1,122.02 |
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 $1,000.00 Typical High $1,995.26 | Professional | None | $602.56 | $1,000.00 | $1,995.26 |
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 $316.23 Median $323.59 Typical High $398.11 | Professional | 52 · Reduced service | $316.23 | $323.59 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $128.82 Typical High $158.49 | Professional | 53 · Discontinued | $125.89 | $128.82 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $489.78 Typical High $588.84 | Professional | 54 · Surgery only | $478.63 | $489.78 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $97.72 Typical High $117.49 | Professional | 55 · Aftercare only | $95.50 | $97.72 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $64.57 Typical High $79.43 | Professional | 56 · Pre-op care only | $63.10 | $64.57 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $457.09 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $446.68 | $457.09 | $549.54 |
Where Georgia sits
The same service costs 5.9 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· 29th of 51
$1,000
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.