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 $831.76 Median $5,011.87 Typical High $7,943.28 | Facility | None | $831.76 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,862.09 | Professional | None | $812.83 | $812.83 | $1,862.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $512.86 Median $1,621.81 Typical High $15,848.93 | Facility | None | $512.86 | $1,621.81 | $15,848.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $724.44 Median $1,096.48 Typical High $1,778.28 | Professional | None | $724.44 | $1,096.48 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $501.19 Median $691.83 Typical High $1,122.02 | Professional | 62 · Two surgeons | $501.19 | $691.83 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $128.82 Median $177.83 Typical High $309.03 | Professional | 80 · Assistant surgeon | $128.82 | $177.83 | $309.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $154.88 Typical High $251.19 | Professional | AS · PA/NP assist | $112.20 | $154.88 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $18,620.87 Typical High $24,547.09 | Facility | None | $537.03 | $18,620.87 | $24,547.09 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,258.93 Typical High $2,187.76 | Professional | None | $912.01 | $1,258.93 | $2,187.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $741.31 Median $912.01 Typical High $2,398.83 | Professional | None | $741.31 | $912.01 | $2,398.83 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $6,760.83 Typical High $12,882.50 | Facility | None | $1,513.56 | $6,760.83 | $12,882.50 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,230.27 Typical High $2,454.71 | Professional | None | $831.76 | $1,230.27 | $2,454.71 |
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 $407.38 Median $407.38 Typical High $478.63 | Professional | 52 · Reduced service | $407.38 | $407.38 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $194.98 | Professional | 53 · Discontinued | $162.18 | $162.18 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $724.44 | Professional | 54 · Surgery only | $602.56 | $602.56 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $144.54 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $97.72 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $676.08 |
Where Georgia sits
The same service costs 6.8 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· 28th of 51
$1,148
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.