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 $1,202.26 Median $5,011.87 Typical High $7,943.28 | Facility | None | $1,202.26 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $2,570.40 | Professional | None | $1,174.90 | $1,174.90 | $2,570.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $512.86 Median $1,174.90 Typical High $7,244.36 | Facility | None | $512.86 | $1,174.90 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,023.29 Median $1,584.89 Typical High $2,570.40 | Professional | None | $1,023.29 | $1,584.89 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $724.44 Median $1,000.00 Typical High $1,659.59 | Professional | 62 · Two surgeons | $724.44 | $1,000.00 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $257.04 Typical High $446.68 | Professional | 80 · Assistant surgeon | $181.97 | $257.04 | $446.68 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $223.87 Typical High $371.54 | Professional | AS · PA/NP assist | $162.18 | $223.87 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $3,090.30 Typical High $3,801.89 | Facility | None | $537.03 | $3,090.30 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,819.70 Typical High $3,162.28 | Professional | None | $1,318.26 | $1,819.70 | $3,162.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,047.13 Median $1,318.26 Typical High $3,311.31 | Professional | None | $1,047.13 | $1,318.26 | $3,311.31 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $7,585.78 | Facility | None | $954.99 | $1,995.26 | $7,585.78 |
United Setting Professional Modifier None Typical Low $1,202.26 Median $1,778.28 Typical High $3,548.13 | Professional | None | $1,202.26 | $1,778.28 | $3,548.13 |
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 $588.84 Median $588.84 Typical High $707.95 | Professional | 52 · Reduced service | $588.84 | $588.84 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $281.84 | Professional | 53 · Discontinued | $234.42 | $234.42 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $870.96 Typical High $1,047.13 | Professional | 54 · Surgery only | $870.96 | $870.96 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $208.93 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $141.25 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $812.83 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $812.83 | $812.83 | $977.24 |
Where Georgia sits
The same service costs 5.8 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
$1,585
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.