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 $1,023.29 Median $5,011.87 Typical High $10,000.00 | Facility | None | $1,023.29 | $5,011.87 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,548.82 | Professional | None | $1,023.29 | $1,023.29 | $1,548.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $512.86 Median $1,000.00 Typical High $4,570.88 | Facility | None | $512.86 | $1,000.00 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,412.54 Typical High $2,398.83 | Professional | None | $912.01 | $1,412.54 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $630.96 Median $891.25 Typical High $1,548.82 | Professional | 62 · Two surgeons | $630.96 | $891.25 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,202.26 Typical High $2,511.89 | Facility | None | $602.56 | $1,202.26 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,548.82 Typical High $2,818.38 | Professional | None | $1,148.15 | $1,548.82 | $2,818.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $933.25 Median $1,174.90 Typical High $1,905.46 | Professional | None | $933.25 | $1,174.90 | $1,905.46 |
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 $1,023.29 Median $1,479.11 Typical High $3,162.28 | Professional | None | $1,023.29 | $1,479.11 | $3,162.28 |
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 $512.86 Median $512.86 Typical High $616.60 | Professional | 52 · Reduced service | $512.86 | $512.86 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $208.93 Typical High $245.47 | Professional | 53 · Discontinued | $208.93 | $208.93 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $933.25 | Professional | 54 · Surgery only | $776.25 | $776.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $154.88 Typical High $186.21 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $123.03 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $870.96 |
Where Georgia sits
The same service costs 5.9 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· 26th of 51
$1,413
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.