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 $128.82 Median $3,630.78 Typical High $7,943.28 | Facility | None | $128.82 | $3,630.78 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $128.82 Typical High $5,370.32 | Professional | None | $117.49 | $128.82 | $5,370.32 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,000.00 Median $3,019.95 Typical High $6,025.60 | Facility | None | $1,000.00 | $3,019.95 | $6,025.60 |
Anthem BCBS Setting Professional Modifier None Typical Low $117.49 Median $169.82 Typical High $208.93 | Professional | None | $117.49 | $169.82 | $208.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $19.50 Median $26.30 Typical High $33.88 | Professional | 80 · Assistant surgeon | $19.50 | $26.30 | $33.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $16.98 Median $23.44 Typical High $26.92 | Professional | AS · PA/NP assist | $16.98 | $23.44 | $26.92 |
Kaiser Permanente Setting Professional Modifier None Typical Low $112.20 Median $891.25 Typical High $1,148.15 | Professional | None | $112.20 | $891.25 | $1,148.15 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $3,548.13 Typical High $5,495.41 | Facility | None | $1,621.81 | $3,548.13 | $5,495.41 |
United Setting Professional Modifier None Typical Low $131.83 Median $194.98 Typical High $27,542.29 | Professional | None | $131.83 | $194.98 | $27,542.29 |
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 $58.88 Median $61.66 Typical High $70.79 | Professional | 52 · Reduced service | $58.88 | $61.66 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $24.55 Typical High $28.18 | Professional | 53 · Discontinued | $23.44 | $24.55 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $91.20 Typical High $104.71 | Professional | 54 · Surgery only | $87.10 | $91.20 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $18.62 Typical High $20.89 | Professional | 55 · Aftercare only | $17.38 | $18.62 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $12.30 Typical High $14.13 | Professional | 56 · Pre-op care only | $11.75 | $12.30 | $14.13 |
Where Georgia sits
The same service costs 37.2 times more in Oklahoma than in New York. 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· 34th of 51
$182
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.