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 $588.84 Median $5,370.32 Typical High $7,943.28 | Facility | None | $588.84 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $346.74 Typical High $1,000.00 | Professional | None | $269.15 | $346.74 | $1,000.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $562.34 Median $1,071.52 Typical High $4,570.88 | Facility | None | $562.34 | $1,071.52 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $288.40 Median $467.74 Typical High $851.14 | Professional | None | $288.40 | $467.74 | $851.14 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $52.48 Median $74.13 Typical High $138.04 | Professional | 80 · Assistant surgeon | $52.48 | $74.13 | $138.04 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $46.77 Median $66.07 Typical High $117.49 | Professional | AS · PA/NP assist | $46.77 | $66.07 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,995.26 Typical High $2,630.27 | Facility | None | $602.56 | $1,995.26 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $512.86 Typical High $933.25 | Professional | None | $323.59 | $512.86 | $933.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $309.03 Median $371.54 Typical High $741.31 | Professional | None | $309.03 | $371.54 | $741.31 |
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 $316.23 Median $457.09 Typical High $758.58 | Professional | None | $316.23 | $457.09 | $758.58 |
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 $134.90 Median $134.90 Typical High $186.21 | Professional | 52 · Reduced service | $134.90 | $134.90 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $53.70 Typical High $74.13 | Professional | 53 · Discontinued | $53.70 | $53.70 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $204.17 Typical High $275.42 | Professional | 54 · Surgery only | $204.17 | $204.17 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $40.74 Typical High $54.95 | Professional | 55 · Aftercare only | $40.74 | $40.74 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $26.92 Typical High $37.15 | Professional | 56 · Pre-op care only | $26.92 | $26.92 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $190.55 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $190.55 | $190.55 | $257.04 |
Where Georgia sits
The same service costs 11.2 times more in Oklahoma 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· 25th of 51
$513
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.