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 $977.24 Median $977.24 Typical High $2,137.96 | Professional | None | $977.24 | $977.24 | $2,137.96 |
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 $954.99 Median $1,288.25 Typical High $2,089.30 | Professional | None | $954.99 | $1,288.25 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $616.60 Median $831.76 Typical High $1,412.54 | Professional | 62 · Two surgeons | $616.60 | $831.76 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $213.80 Typical High $363.08 | Professional | 80 · Assistant surgeon | $154.88 | $213.80 | $363.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $181.97 Typical High $309.03 | Professional | AS · PA/NP assist | $134.90 | $181.97 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $5,495.41 Typical High $6,918.31 | Facility | None | $602.56 | $5,495.41 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,548.82 Typical High $2,630.27 | Professional | None | $1,096.48 | $1,548.82 | $2,630.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $870.96 Median $1,096.48 Typical High $2,754.23 | Professional | None | $870.96 | $1,096.48 | $2,754.23 |
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 $977.24 Median $1,479.11 Typical High $2,630.27 | Professional | None | $977.24 | $1,479.11 | $2,630.27 |
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 $489.78 Median $489.78 Typical High $630.96 | Professional | 52 · Reduced service | $489.78 | $489.78 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $251.19 | Professional | 53 · Discontinued | $194.98 | $194.98 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $933.25 | Professional | 54 · Surgery only | $724.44 | $724.44 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $190.55 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $125.89 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $676.08 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $676.08 | $676.08 | $870.96 |
Where Georgia sits
The same service costs 6.3 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
$1,349
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.