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 $436.52 Median $3,630.78 Typical High $7,943.28 | Facility | None | $436.52 | $3,630.78 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $831.76 | Professional | None | $436.52 | $436.52 | $831.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $831.76 Typical High $4,570.88 | Facility | None | $389.05 | $831.76 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $380.19 Median $588.84 Typical High $933.25 | Professional | None | $380.19 | $588.84 | $933.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $630.96 Median $870.96 Typical High $1,445.44 | Professional | 50 · Both sides | $630.96 | $870.96 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $67.61 Median $95.50 Typical High $162.18 | Professional | 80 · Assistant surgeon | $67.61 | $95.50 | $162.18 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $58.88 Median $81.28 Typical High $131.83 | Professional | AS · PA/NP assist | $58.88 | $81.28 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $1,148.15 Typical High $1,513.56 | Facility | None | $398.11 | $1,148.15 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $660.69 Typical High $1,174.90 | Professional | None | $478.63 | $660.69 | $1,174.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $398.11 Median $501.19 Typical High $1,071.52 | Professional | None | $398.11 | $501.19 | $1,071.52 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,479.11 Typical High $5,011.87 | Facility | None | $851.14 | $1,479.11 | $5,011.87 |
United Setting Professional Modifier None Typical Low $436.52 Median $630.96 Typical High $1,202.26 | Professional | None | $436.52 | $630.96 | $1,202.26 |
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 $218.78 Median $218.78 Typical High $281.84 | Professional | 52 · Reduced service | $218.78 | $218.78 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $87.10 Typical High $112.20 | Professional | 53 · Discontinued | $87.10 | $87.10 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $323.59 Typical High $416.87 | Professional | 54 · Surgery only | $323.59 | $323.59 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $64.57 Typical High $83.18 | Professional | 55 · Aftercare only | $64.57 | $64.57 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $43.65 Typical High $56.23 | Professional | 56 · Pre-op care only | $43.65 | $43.65 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $302.00 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $302.00 | $302.00 | $389.05 |
Where Georgia sits
The same service costs 5.1 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
$617
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.