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 $213.80 Median $5,370.32 Typical High $7,943.28 | Facility | None | $213.80 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $562.34 | Professional | None | $213.80 | $213.80 | $562.34 |
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 $194.98 Median $229.09 Typical High $416.87 | Professional | None | $194.98 | $229.09 | $416.87 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $123.03 Median $144.54 Typical High $269.15 | Professional | 62 · Two surgeons | $123.03 | $144.54 | $269.15 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $31.62 Median $41.69 Typical High $69.18 | Professional | 80 · Assistant surgeon | $31.62 | $41.69 | $69.18 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $27.54 Median $32.36 Typical High $60.26 | Professional | AS · PA/NP assist | $27.54 | $32.36 | $60.26 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $549.54 Typical High $2,511.89 | Facility | None | $446.68 | $549.54 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $354.81 Typical High $724.44 | Professional | None | $239.88 | $354.81 | $724.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $218.78 Median $281.84 Typical High $812.83 | Professional | None | $218.78 | $281.84 | $812.83 |
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 $186.21 Median $275.42 Typical High $676.08 | Professional | None | $186.21 | $275.42 | $676.08 |
3 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 54 · Surgery only Typical Low $162.18 Median $162.18 Typical High $190.55 | Professional | 54 · Surgery only | $162.18 | $162.18 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $32.36 Typical High $38.02 | Professional | 55 · Aftercare only | $32.36 | $32.36 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $21.38 Typical High $25.12 | Professional | 56 · Pre-op care only | $21.38 | $21.38 | $25.12 |
Where Georgia sits
The same service costs 8.5 times more in New York than in Kentucky. 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· 37th of 51
$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.