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 $630.96 Median $3,548.13 Typical High $7,585.78 | Facility | None | $630.96 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $1,380.38 | Professional | None | $354.81 | $354.81 | $1,380.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $1,000.00 Typical High $5,754.40 | Facility | None | $389.05 | $1,000.00 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $316.23 Median $478.63 Typical High $794.33 | Professional | None | $316.23 | $478.63 | $794.33 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $524.81 Median $724.44 Typical High $1,348.96 | Professional | 50 · Both sides | $524.81 | $724.44 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $60.26 Median $83.18 Typical High $154.88 | Professional | 80 · Assistant surgeon | $60.26 | $83.18 | $154.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $48.98 Median $67.61 Typical High $128.82 | Professional | AS · PA/NP assist | $48.98 | $67.61 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $1,949.84 Typical High $2,454.71 | Facility | None | $398.11 | $1,949.84 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $549.54 Typical High $1,148.15 | Professional | None | $398.11 | $549.54 | $1,148.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $331.13 Median $407.38 Typical High $1,778.28 | Professional | None | $331.13 | $407.38 | $1,778.28 |
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 $363.08 Median $512.86 Typical High $977.24 | Professional | None | $363.08 | $512.86 | $977.24 |
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 $177.83 Median $177.83 Typical High $229.09 | Professional | 52 · Reduced service | $177.83 | $177.83 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $72.44 Typical High $91.20 | Professional | 53 · Discontinued | $72.44 | $72.44 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $269.15 Typical High $346.74 | Professional | 54 · Surgery only | $269.15 | $269.15 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $53.70 Typical High $69.18 | Professional | 55 · Aftercare only | $53.70 | $53.70 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $35.48 Typical High $45.71 | Professional | 56 · Pre-op care only | $35.48 | $35.48 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $251.19 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $251.19 | $251.19 | $323.59 |
Where Georgia sits
The same service costs 6.9 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· 30th of 51
$525
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.