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 $616.60 Median $6,309.57 Typical High $10,000.00 | Facility | None | $616.60 | $6,309.57 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $1,513.56 | Professional | None | $588.84 | $588.84 | $1,513.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $691.83 Median $1,380.38 Typical High $7,244.36 | Facility | None | $691.83 | $1,380.38 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $588.84 Median $812.83 Typical High $1,318.26 | Professional | None | $588.84 | $812.83 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $371.54 Median $512.86 Typical High $870.96 | Professional | 62 · Two surgeons | $371.54 | $512.86 | $870.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $95.50 Median $131.83 Typical High $223.87 | Professional | 80 · Assistant surgeon | $95.50 | $131.83 | $223.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $83.18 Median $112.20 Typical High $194.98 | Professional | AS · PA/NP assist | $83.18 | $112.20 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,691.53 Typical High $3,467.37 | Facility | None | $602.56 | $2,691.53 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $933.25 Typical High $1,621.81 | Professional | None | $660.69 | $933.25 | $1,621.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $537.03 Median $676.08 Typical High $1,949.84 | Professional | None | $537.03 | $676.08 | $1,949.84 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $2,884.03 Typical High $8,709.64 | Facility | None | $1,258.93 | $2,884.03 | $8,709.64 |
United Setting Professional Modifier None Typical Low $602.56 Median $933.25 Typical High $1,819.70 | Professional | None | $602.56 | $933.25 | $1,819.70 |
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 $295.12 Median $295.12 Typical High $354.81 | Professional | 52 · Reduced service | $295.12 | $295.12 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $120.23 Typical High $141.25 | Professional | 53 · Discontinued | $120.23 | $120.23 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $446.68 Typical High $537.03 | Professional | 54 · Surgery only | $446.68 | $446.68 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $89.13 Typical High $107.15 | Professional | 55 · Aftercare only | $89.13 | $89.13 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $58.88 Typical High $70.79 | Professional | 56 · Pre-op care only | $58.88 | $58.88 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $416.87 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $416.87 | $416.87 | $501.19 |
Where Georgia sits
The same service costs 9.8 times more in Oklahoma 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· 29th of 51
$871
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.