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 $707.95 Median $7,079.46 Typical High $12,302.69 | Facility | None | $707.95 | $7,079.46 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $977.24 | Professional | None | $707.95 | $707.95 | $977.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $1,698.24 Typical High $7,244.36 | Facility | None | $954.99 | $1,698.24 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $575.44 Median $977.24 Typical High $1,584.89 | Professional | None | $575.44 | $977.24 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $181.97 Typical High $281.84 | Professional | 80 · Assistant surgeon | $120.23 | $181.97 | $281.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $147.91 Typical High $245.47 | Professional | AS · PA/NP assist | $107.15 | $147.91 | $245.47 |
CareSource Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | None | $645.65 | $645.65 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $1,122.02 Median $3,467.37 Typical High $4,677.35 | Facility | None | $1,122.02 | $3,467.37 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,122.02 Typical High $1,862.09 | Professional | None | $776.25 | $1,122.02 | $1,862.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $758.58 Median $933.25 Typical High $2,511.89 | Professional | None | $758.58 | $933.25 | $2,511.89 |
Oscar Health Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $2,884.03 Typical High $8,709.64 | Facility | None | $1,258.93 | $2,884.03 | $8,709.64 |
United Setting Professional Modifier None Typical Low $676.08 Median $1,174.90 Typical High $2,187.76 | Professional | None | $676.08 | $1,174.90 | $2,187.76 |
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 $354.81 Median $354.81 Typical High $446.68 | Professional | 52 · Reduced service | $354.81 | $354.81 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $141.25 Typical High $177.83 | Professional | 53 · Discontinued | $141.25 | $141.25 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $537.03 Typical High $676.08 | Professional | 54 · Surgery only | $537.03 | $537.03 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $107.15 Typical High $134.90 | Professional | 55 · Aftercare only | $107.15 | $107.15 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $89.13 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $501.19 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $501.19 | $501.19 | $630.96 |
Where Georgia sits
The same service costs 6.3 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· 20th 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.