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 $501.19 Median $5,370.32 Typical High $7,943.28 | Facility | None | $501.19 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $562.34 Typical High $741.31 | Professional | None | $501.19 | $562.34 | $741.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $691.83 Median $1,348.96 Typical High $7,244.36 | Facility | None | $691.83 | $1,348.96 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $588.84 Median $870.96 Typical High $1,479.11 | Professional | None | $588.84 | $870.96 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $398.11 Median $549.54 Typical High $933.25 | Professional | 62 · Two surgeons | $398.11 | $549.54 | $933.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $100.00 Median $158.49 Typical High $263.03 | Professional | 80 · Assistant surgeon | $100.00 | $158.49 | $263.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $87.10 Median $125.89 Typical High $213.80 | Professional | AS · PA/NP assist | $87.10 | $125.89 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,691.53 Typical High $3,467.37 | Facility | None | $602.56 | $2,691.53 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $1,000.00 Typical High $1,698.24 | Professional | None | $616.60 | $1,000.00 | $1,698.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $562.34 Median $707.95 Typical High $1,995.26 | Professional | None | $562.34 | $707.95 | $1,995.26 |
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 $616.60 Median $870.96 Typical High $1,445.44 | Professional | None | $616.60 | $870.96 | $1,445.44 |
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 $251.19 Median $251.19 Typical High $338.84 | Professional | 52 · Reduced service | $251.19 | $251.19 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $100.00 Typical High $138.04 | Professional | 53 · Discontinued | $100.00 | $100.00 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $380.19 Typical High $512.86 | Professional | 54 · Surgery only | $380.19 | $380.19 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $75.86 Typical High $102.33 | Professional | 55 · Aftercare only | $75.86 | $75.86 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $50.12 Typical High $69.18 | Professional | 56 · Pre-op care only | $50.12 | $50.12 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $354.81 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $354.81 | $354.81 | $478.63 |
Where Georgia sits
The same service costs 6.2 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· 18th of 51
$1,000
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.