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 $724.44 Median $5,370.32 Typical High $7,943.28 | Facility | None | $724.44 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $1,047.13 | Professional | None | $724.44 | $724.44 | $1,047.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,862.09 Typical High $7,943.28 | Facility | None | $588.84 | $1,862.09 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $630.96 Median $977.24 Typical High $1,584.89 | Professional | None | $630.96 | $977.24 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $446.68 Median $616.60 Typical High $1,023.29 | Professional | 62 · Two surgeons | $446.68 | $616.60 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $158.49 Typical High $269.15 | Professional | 80 · Assistant surgeon | $114.82 | $158.49 | $269.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $138.04 Typical High $229.09 | Professional | AS · PA/NP assist | $100.00 | $138.04 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $549.54 Typical High $2,398.83 | Facility | None | $457.09 | $549.54 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,122.02 Typical High $1,995.26 | Professional | None | $812.83 | $1,122.02 | $1,995.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $660.69 Median $831.76 Typical High $1,348.96 | Professional | None | $660.69 | $831.76 | $1,348.96 |
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 $741.31 Median $1,071.52 Typical High $2,187.76 | Professional | None | $741.31 | $1,071.52 | $2,187.76 |
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 $363.08 Median $363.08 Typical High $436.52 | Professional | 52 · Reduced service | $363.08 | $363.08 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $173.78 | Professional | 53 · Discontinued | $144.54 | $144.54 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $645.65 | Professional | 54 · Surgery only | $549.54 | $549.54 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $131.83 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $87.10 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $512.86 | $512.86 | $602.56 |
Where Georgia sits
The same service costs 5.4 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· 30th of 51
$977
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.