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 $724.44 Median $5,370.32 Typical High $8,317.64 | Facility | None | $724.44 | $5,370.32 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $1,412.54 | Professional | None | $724.44 | $724.44 | $1,412.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $660.69 Median $1,202.26 Typical High $4,570.88 | Facility | None | $660.69 | $1,202.26 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $645.65 Median $977.24 Typical High $1,548.82 | Professional | None | $645.65 | $977.24 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $154.88 Typical High $295.12 | Professional | 80 · Assistant surgeon | $112.20 | $154.88 | $295.12 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $134.90 Typical High $229.09 | Professional | AS · PA/NP assist | $100.00 | $134.90 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,995.26 Typical High $2,691.53 | Facility | None | $741.31 | $1,995.26 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,122.02 Typical High $1,949.84 | Professional | None | $812.83 | $1,122.02 | $1,949.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $645.65 Median $812.83 Typical High $1,288.25 | Professional | None | $645.65 | $812.83 | $1,288.25 |
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 $741.31 Median $1,071.52 Typical High $1,995.26 | Professional | None | $741.31 | $1,071.52 | $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 $363.08 Median $363.08 Typical High $467.74 | Professional | 52 · Reduced service | $363.08 | $363.08 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $186.21 | Professional | 53 · Discontinued | $144.54 | $144.54 | $186.21 |
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 $72.44 Median $72.44 Typical High $93.33 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $93.33 |
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 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· 29th of 51
$1,023
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.