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 $1,548.82 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,548.82 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $2,041.74 | Professional | None | $1,548.82 | $1,548.82 | $2,041.74 |
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 $1,380.38 Median $2,089.30 Typical High $3,311.31 | Professional | None | $1,380.38 | $2,089.30 | $3,311.31 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $245.47 Median $338.84 Typical High $575.44 | Professional | 80 · Assistant surgeon | $245.47 | $338.84 | $575.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $213.80 Median $295.12 Typical High $489.78 | Professional | AS · PA/NP assist | $213.80 | $295.12 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $549.54 Typical High $2,511.89 | Facility | None | $446.68 | $549.54 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $1,737.80 Median $2,398.83 Typical High $4,168.69 | Professional | None | $1,737.80 | $2,398.83 | $4,168.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,380.38 Median $1,737.80 Typical High $4,466.84 | Professional | None | $1,380.38 | $1,737.80 | $4,466.84 |
United Setting Facility Modifier None Typical Low $371.54 Median $645.65 Typical High $3,981.07 | Facility | None | $371.54 | $645.65 | $3,981.07 |
United Setting Professional Modifier None Typical Low $1,584.89 Median $2,290.87 Typical High $4,265.80 | Professional | None | $1,584.89 | $2,290.87 | $4,265.80 |
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 $776.25 Median $776.25 Typical High $1,000.00 | Professional | 52 · Reduced service | $776.25 | $776.25 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $309.03 Typical High $407.38 | Professional | 53 · Discontinued | $309.03 | $309.03 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,174.90 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,174.90 | $1,174.90 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $234.42 Typical High $302.00 | Professional | 55 · Aftercare only | $234.42 | $234.42 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $154.88 Typical High $199.53 | Professional | 56 · Pre-op care only | $154.88 | $154.88 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,096.48 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,096.48 | $1,412.54 |
Where Georgia sits
The same service costs 6.0 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· 19th of 51
$2,089
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.