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 $239.88 Median $5,370.32 Typical High $7,943.28 | Facility | None | $239.88 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $354.81 | Professional | None | $239.88 | $239.88 | $354.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,862.09 Typical High $8,128.31 | Facility | None | $588.84 | $1,862.09 | $8,128.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $229.09 Median $346.74 Typical High $588.84 | Professional | None | $229.09 | $346.74 | $588.84 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $165.96 Median $229.09 Typical High $389.05 | Professional | 62 · Two surgeons | $165.96 | $229.09 | $389.05 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $41.69 Median $64.57 Typical High $100.00 | Professional | 80 · Assistant surgeon | $41.69 | $64.57 | $100.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $36.31 Median $50.12 Typical High $85.11 | Professional | AS · PA/NP assist | $36.31 | $50.12 | $85.11 |
CareSource Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $831.76 Typical High $4,265.80 | Facility | None | $512.86 | $831.76 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $436.52 Typical High $758.58 | Professional | None | $281.84 | $436.52 | $758.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $263.03 Median $316.23 Typical High $1,698.24 | Professional | None | $263.03 | $316.23 | $1,698.24 |
Oscar Health Setting Professional Modifier None Typical Low $288.40 Median $389.05 Typical High $426.58 | Professional | None | $288.40 | $389.05 | $426.58 |
United Setting Facility Modifier None Typical Low $371.54 Median $645.65 Typical High $3,981.07 | Facility | None | $371.54 | $645.65 | $3,981.07 |
United Setting Professional Modifier None Typical Low $229.09 Median $407.38 Typical High $794.33 | Professional | None | $229.09 | $407.38 | $794.33 |
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 $120.23 Median $120.23 Typical High $158.49 | Professional | 52 · Reduced service | $120.23 | $120.23 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $48.98 Typical High $63.10 | Professional | 53 · Discontinued | $48.98 | $48.98 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $181.97 Typical High $239.88 | Professional | 54 · Surgery only | $181.97 | $181.97 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $36.31 Typical High $47.86 | Professional | 55 · Aftercare only | $36.31 | $36.31 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $23.99 Typical High $31.62 | Professional | 56 · Pre-op care only | $23.99 | $23.99 | $31.62 |
Where Georgia sits
The same service costs 5.0 times more in Alaska than in Utah. 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
$363
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.