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 $977.24 Median $5,370.32 Typical High $7,943.28 | Facility | None | $977.24 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,584.89 | Professional | None | $741.31 | $741.31 | $1,584.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,230.27 Typical High $7,244.36 | Facility | None | $588.84 | $1,230.27 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $645.65 Median $1,000.00 Typical High $1,584.89 | Professional | None | $645.65 | $1,000.00 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $457.09 Median $630.96 Typical High $1,071.52 | Professional | 62 · Two surgeons | $457.09 | $630.96 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $162.18 Typical High $275.42 | Professional | 80 · Assistant surgeon | $117.49 | $162.18 | $275.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $147.91 Typical High $263.03 | Professional | AS · PA/NP assist | $100.00 | $147.91 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,019.95 Typical High $3,890.45 | Facility | None | $602.56 | $3,019.95 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,148.15 Typical High $1,995.26 | Professional | None | $812.83 | $1,148.15 | $1,995.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $660.69 Median $831.76 Typical High $2,041.74 | Professional | None | $660.69 | $831.76 | $2,041.74 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $2,884.03 Typical High $8,709.64 | Facility | None | $1,258.93 | $2,884.03 | $8,709.64 |
United Setting Professional Modifier None Typical Low $741.31 Median $1,096.48 Typical High $1,995.26 | Professional | None | $741.31 | $1,096.48 | $1,995.26 |
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 $371.54 Median $371.54 Typical High $478.63 | Professional | 52 · Reduced service | $371.54 | $371.54 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $190.55 | Professional | 53 · Discontinued | $147.91 | $147.91 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $707.95 | Professional | 54 · Surgery only | $549.54 | $549.54 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $141.25 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $95.50 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $512.86 | $512.86 | $660.69 |
Where Georgia sits
The same service costs 8.7 times more in Oklahoma 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· 28th 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.