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 $1,202.26 Median $5,623.41 Typical High $9,549.93 | Facility | None | $1,202.26 | $5,623.41 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $977.24 | Professional | None | $741.31 | $741.31 | $977.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $776.25 Median $1,479.11 Typical High $7,244.36 | Facility | None | $776.25 | $1,479.11 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $616.60 Median $1,023.29 Typical High $1,621.81 | Professional | None | $616.60 | $1,023.29 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $186.21 Typical High $269.15 | Professional | 80 · Assistant surgeon | $117.49 | $186.21 | $269.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $144.54 Typical High $223.87 | Professional | AS · PA/NP assist | $107.15 | $144.54 | $223.87 |
CareSource Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $3,467.37 Typical High $4,365.16 | Facility | None | $812.83 | $3,467.37 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,148.15 Typical High $1,949.84 | Professional | None | $794.33 | $1,148.15 | $1,949.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $812.83 Median $977.24 Typical High $1,819.70 | Professional | None | $812.83 | $977.24 | $1,819.70 |
Oscar Health Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
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 $691.83 Median $1,230.27 Typical High $2,290.87 | Professional | None | $691.83 | $1,230.27 | $2,290.87 |
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 $371.54 Median $371.54 Typical High $467.74 | Professional | 52 · Reduced service | $371.54 | $371.54 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $186.21 | Professional | 53 · Discontinued | $147.91 | $147.91 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $691.83 | Professional | 54 · Surgery only | $549.54 | $549.54 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $138.04 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $93.33 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $512.86 | $512.86 | $645.65 |
Where Georgia sits
The same service costs 6.2 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· 19th of 51
$1,023
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.