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 $851.14 Median $5,370.32 Typical High $7,943.28 | Facility | None | $851.14 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $851.14 Typical High $977.24 | Professional | None | $660.69 | $851.14 | $977.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $691.83 Median $1,380.38 Typical High $7,244.36 | Facility | None | $691.83 | $1,380.38 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $707.95 Median $1,202.26 Typical High $1,778.28 | Professional | None | $707.95 | $1,202.26 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $190.55 Typical High $288.40 | Professional | 80 · Assistant surgeon | $131.83 | $190.55 | $288.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $169.82 Typical High $251.19 | Professional | AS · PA/NP assist | $120.23 | $169.82 | $251.19 |
CareSource Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None | $616.60 | $616.60 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $3,388.44 Typical High $4,365.16 | Facility | None | $741.31 | $3,388.44 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $1,122.02 Typical High $1,819.70 | Professional | None | $724.44 | $1,122.02 | $1,819.70 |
Kaiser Permanente Setting Professional Modifier None Typical Low $691.83 Median $1,047.13 Typical High $1,230.27 | Professional | None | $691.83 | $1,047.13 | $1,230.27 |
Oscar Health Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | None | $794.33 | $794.33 | $794.33 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,479.11 Typical High $5,011.87 | Facility | None | $851.14 | $1,479.11 | $5,011.87 |
United Setting Professional Modifier None Typical Low $691.83 Median $1,174.90 Typical High $2,344.23 | Professional | None | $691.83 | $1,174.90 | $2,344.23 |
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 $331.13 Median $426.58 Typical High $478.63 | Professional | 52 · Reduced service | $331.13 | $426.58 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $169.82 Typical High $194.98 | Professional | 53 · Discontinued | $131.83 | $169.82 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $630.96 Typical High $724.44 | Professional | 54 · Surgery only | $489.78 | $630.96 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $128.82 Typical High $144.54 | Professional | 55 · Aftercare only | $97.72 | $128.82 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $85.11 Typical High $97.72 | Professional | 56 · Pre-op care only | $66.07 | $85.11 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $588.84 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $457.09 | $588.84 | $676.08 |
Where Georgia sits
The same service costs 4.4 times more in Alaska than in New Jersey. 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· 14th of 51
$1,148
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.