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 $1,621.81 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,621.81 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $2,041.74 | Professional | None | $1,621.81 | $1,621.81 | $2,041.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $707.95 Median $2,290.87 Typical High $10,715.19 | Facility | None | $707.95 | $2,290.87 | $10,715.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,380.38 Median $2,187.76 Typical High $3,548.13 | Professional | None | $1,380.38 | $2,187.76 | $3,548.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $245.47 Median $354.81 Typical High $602.56 | Professional | 80 · Assistant surgeon | $245.47 | $354.81 | $602.56 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $213.80 Median $309.03 Typical High $537.03 | Professional | AS · PA/NP assist | $213.80 | $309.03 | $537.03 |
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 $1,698.24 Median $2,344.23 Typical High $4,466.84 | Professional | None | $1,698.24 | $2,344.23 | $4,466.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,513.56 Median $1,905.46 Typical High $3,090.30 | Professional | None | $1,513.56 | $1,905.46 | $3,090.30 |
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 $1,513.56 Median $2,187.76 Typical High $4,897.79 | Professional | None | $1,513.56 | $2,187.76 | $4,897.79 |
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 $812.83 Median $812.83 Typical High $977.24 | Professional | 52 · Reduced service | $812.83 | $812.83 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $323.59 Typical High $389.05 | Professional | 53 · Discontinued | $323.59 | $323.59 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,202.26 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,202.26 | $1,202.26 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $245.47 Typical High $288.40 | Professional | 55 · Aftercare only | $245.47 | $245.47 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $162.18 Typical High $194.98 | Professional | 56 · Pre-op care only | $162.18 | $162.18 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,122.02 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,122.02 | $1,348.96 |
Where Georgia sits
The same service costs 5.6 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· 20th of 51
$2,089
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.