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 $977.24 Median $5,370.32 Typical High $10,000.00 | Facility | None | $977.24 | $5,370.32 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,862.09 | Professional | None | $933.25 | $933.25 | $1,862.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $602.56 Median $2,041.74 Typical High $10,715.19 | Facility | None | $602.56 | $2,041.74 | $10,715.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $831.76 Median $1,288.25 Typical High $2,187.76 | Professional | None | $831.76 | $1,288.25 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,380.38 Median $1,905.46 Typical High $3,388.44 | Professional | 50 · Both sides | $1,380.38 | $1,905.46 | $3,388.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $588.84 Median $812.83 Typical High $1,412.54 | Professional | 62 · Two surgeons | $588.84 | $812.83 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $549.54 Typical High $2,511.89 | Facility | None | $478.63 | $549.54 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,445.44 Typical High $2,570.40 | Professional | None | $1,047.13 | $1,445.44 | $2,570.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $851.14 Median $1,071.52 Typical High $2,398.83 | Professional | None | $851.14 | $1,071.52 | $2,398.83 |
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 $954.99 Median $1,380.38 Typical High $2,884.03 | Professional | None | $954.99 | $1,380.38 | $2,884.03 |
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 $467.74 Median $467.74 Typical High $562.34 | Professional | 52 · Reduced service | $467.74 | $467.74 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $186.21 Typical High $223.87 | Professional | 53 · Discontinued | $186.21 | $186.21 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $851.14 | Professional | 54 · Surgery only | $707.95 | $707.95 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $169.82 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $93.33 Typical High $112.20 | Professional | 56 · Pre-op care only | $93.33 | $93.33 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $660.69 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $660.69 | $660.69 | $794.33 |
Where Georgia sits
The same service costs 5.6 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
$1,288
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.