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 $602.56 Median $5,623.41 Typical High $10,000.00 | Facility | None | $602.56 | $5,623.41 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $537.03 Typical High $1,698.24 | Professional | None | $446.68 | $537.03 | $1,698.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $2,187.76 Typical High $10,715.19 | Facility | None | $724.44 | $2,187.76 | $10,715.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $489.78 Median $776.25 Typical High $1,318.26 | Professional | None | $489.78 | $776.25 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $346.74 Median $489.78 Typical High $831.76 | Professional | 62 · Two surgeons | $346.74 | $489.78 | $831.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $89.13 Median $138.04 Typical High $218.78 | Professional | 80 · Assistant surgeon | $89.13 | $138.04 | $218.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $77.62 Median $109.65 Typical High $186.21 | Professional | AS · PA/NP assist | $77.62 | $109.65 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $549.54 Typical High $2,398.83 | Facility | None | $501.19 | $549.54 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $891.25 Typical High $1,513.56 | Professional | None | $562.34 | $891.25 | $1,513.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $512.86 Median $616.60 Typical High $1,288.25 | Professional | None | $512.86 | $616.60 | $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 $537.03 Median $776.25 Typical High $1,288.25 | Professional | None | $537.03 | $776.25 | $1,288.25 |
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 $223.87 Median $223.87 Typical High $302.00 | Professional | 52 · Reduced service | $223.87 | $223.87 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $89.13 Typical High $123.03 | Professional | 53 · Discontinued | $89.13 | $89.13 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $338.84 Typical High $457.09 | Professional | 54 · Surgery only | $338.84 | $338.84 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $67.61 Typical High $91.20 | Professional | 55 · Aftercare only | $67.61 | $67.61 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $44.67 Typical High $61.66 | Professional | 56 · Pre-op care only | $44.67 | $44.67 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $316.23 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $316.23 | $316.23 | $426.58 |
Where Georgia sits
The same service costs 6.0 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· 16th of 51
$891
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.