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 $812.83 Median $5,370.32 Typical High $10,000.00 | Facility | None | $812.83 | $5,370.32 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $1,778.28 | Professional | None | $776.25 | $776.25 | $1,778.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $602.56 Median $1,819.70 Typical High $7,943.28 | Facility | None | $602.56 | $1,819.70 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $676.08 Median $1,047.13 Typical High $1,737.80 | Professional | None | $676.08 | $1,047.13 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $489.78 Median $660.69 Typical High $1,122.02 | Professional | 62 · Two surgeons | $489.78 | $660.69 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $169.82 Typical High $295.12 | Professional | 80 · Assistant surgeon | $123.03 | $169.82 | $295.12 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $147.91 Typical High $251.19 | Professional | AS · PA/NP assist | $107.15 | $147.91 | $251.19 |
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 $870.96 Median $1,174.90 Typical High $2,137.96 | Professional | None | $870.96 | $1,174.90 | $2,137.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $707.95 Median $891.25 Typical High $2,290.87 | Professional | None | $707.95 | $891.25 | $2,290.87 |
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 $794.33 Median $1,148.15 Typical High $2,344.23 | Professional | None | $794.33 | $1,148.15 | $2,344.23 |
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 $389.05 Median $389.05 Typical High $467.74 | Professional | 52 · Reduced service | $389.05 | $389.05 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $186.21 | Professional | 53 · Discontinued | $154.88 | $154.88 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $691.83 | Professional | 54 · Surgery only | $588.84 | $588.84 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $138.04 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $93.33 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $549.54 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $549.54 | $549.54 | $645.65 |
Where Georgia sits
The same service costs 5.9 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· 29th of 51
$1,047
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.