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 $3,548.13 Median $5,370.32 Typical High $7,943.28 | Facility | None | $3,548.13 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $4,265.80 | Professional | None | $3,548.13 | $3,548.13 | $4,265.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $1,148.15 Typical High $5,754.40 | Facility | None | $575.44 | $1,148.15 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,951.21 Median $5,011.87 Typical High $7,244.36 | Professional | None | $2,951.21 | $5,011.87 | $7,244.36 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,344.23 Median $3,162.28 Typical High $5,623.41 | Professional | 62 · Two surgeons | $2,344.23 | $3,162.28 | $5,623.41 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $588.84 Median $870.96 Typical High $1,445.44 | Professional | 80 · Assistant surgeon | $588.84 | $870.96 | $1,445.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $512.86 Median $691.83 Typical High $1,258.93 | Professional | AS · PA/NP assist | $512.86 | $691.83 | $1,258.93 |
CareSource Setting Professional Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Professional | None | $3,311.31 | $3,311.31 | $3,311.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,981.07 Median $4,677.35 Typical High $4,897.79 | Professional | None | $3,981.07 | $4,677.35 | $4,897.79 |
Oscar Health Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $3,467.37 | Professional | None | $3,467.37 | $3,467.37 | $3,467.37 |
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 $3,235.94 Median $5,623.41 Typical High $11,481.54 | Professional | None | $3,235.94 | $5,623.41 | $11,481.54 |
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 $1,778.28 Median $1,778.28 Typical High $2,137.96 | Professional | 52 · Reduced service | $1,778.28 | $1,778.28 | $2,137.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $707.95 Median $707.95 Typical High $851.14 | Professional | 53 · Discontinued | $707.95 | $707.95 | $851.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,691.53 Median $2,691.53 Typical High $3,162.28 | Professional | 54 · Surgery only | $2,691.53 | $2,691.53 | $3,162.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $537.03 Median $537.03 Typical High $645.65 | Professional | 55 · Aftercare only | $537.03 | $537.03 | $645.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $354.81 Median $354.81 Typical High $426.58 | Professional | 56 · Pre-op care only | $354.81 | $354.81 | $426.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,511.89 Median $2,511.89 Typical High $2,951.21 | Professional | 78 · Unplanned return to OR | $2,511.89 | $2,511.89 | $2,951.21 |
Where Georgia sits
The same service costs 27.5 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· 22nd of 51
$4,898
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.