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 $316.23 Median $3,630.78 Typical High $7,943.28 | Facility | None | $316.23 | $3,630.78 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $309.03 Typical High $776.25 | Professional | None | $234.42 | $309.03 | $776.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $512.86 Median $1,000.00 Typical High $4,570.88 | Facility | None | $512.86 | $1,000.00 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $251.19 Median $407.38 Typical High $707.95 | Professional | None | $251.19 | $407.38 | $707.95 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $446.68 Median $676.08 Typical High $1,148.15 | Professional | 50 · Both sides | $446.68 | $676.08 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $190.55 Median $288.40 Typical High $478.63 | Professional | 62 · Two surgeons | $190.55 | $288.40 | $478.63 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $46.77 Median $74.13 Typical High $123.03 | Professional | 80 · Assistant surgeon | $46.77 | $74.13 | $123.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $41.69 Median $63.10 Typical High $107.15 | Professional | AS · PA/NP assist | $41.69 | $63.10 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,089.30 Typical High $2,691.53 | Facility | None | $602.56 | $2,089.30 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $467.74 Typical High $794.33 | Professional | None | $288.40 | $467.74 | $794.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $263.03 Median $316.23 Typical High $645.65 | Professional | None | $263.03 | $316.23 | $645.65 |
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 $295.12 Median $426.58 Typical High $676.08 | Professional | None | $295.12 | $426.58 | $676.08 |
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 $117.49 Median $117.49 Typical High $158.49 | Professional | 52 · Reduced service | $117.49 | $117.49 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $46.77 Typical High $64.57 | Professional | 53 · Discontinued | $46.77 | $46.77 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $177.83 Typical High $239.88 | Professional | 54 · Surgery only | $177.83 | $177.83 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $35.48 Typical High $47.86 | Professional | 55 · Aftercare only | $35.48 | $35.48 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $23.44 Typical High $31.62 | Professional | 56 · Pre-op care only | $23.44 | $23.44 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $165.96 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $165.96 | $165.96 | $223.87 |
Where Georgia sits
The same service costs 6.0 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· 23rd of 51
$468
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.