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 $1,445.44 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,445.44 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $3,090.30 | Professional | None | $1,445.44 | $1,445.44 | $3,090.30 |
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 $1,288.25 Median $1,949.84 Typical High $3,090.30 | Professional | None | $1,288.25 | $1,949.84 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $912.01 Median $1,230.27 Typical High $2,089.30 | Professional | 62 · Two surgeons | $912.01 | $1,230.27 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $229.09 Median $323.59 Typical High $549.54 | Professional | 80 · Assistant surgeon | $229.09 | $323.59 | $549.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $275.42 Typical High $467.74 | Professional | AS · PA/NP assist | $204.17 | $275.42 | $467.74 |
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 $1,621.81 Median $2,290.87 Typical High $3,890.45 | Professional | None | $1,621.81 | $2,290.87 | $3,890.45 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,288.25 Median $1,621.81 Typical High $3,890.45 | Professional | None | $1,288.25 | $1,621.81 | $3,890.45 |
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 $1,479.11 Median $2,187.76 Typical High $3,981.07 | Professional | None | $1,479.11 | $2,187.76 | $3,981.07 |
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 $724.44 Median $724.44 Typical High $933.25 | Professional | 52 · Reduced service | $724.44 | $724.44 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $288.40 Typical High $380.19 | Professional | 53 · Discontinued | $288.40 | $288.40 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,096.48 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,096.48 | $1,096.48 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $218.78 Typical High $281.84 | Professional | 55 · Aftercare only | $218.78 | $218.78 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $144.54 Typical High $190.55 | Professional | 56 · Pre-op care only | $144.54 | $144.54 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,023.29 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,023.29 | $1,318.26 |
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· 31st of 51
$1,950
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.