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 $741.31 Median $7,079.46 Typical High $12,302.69 | Facility | None | $741.31 | $7,079.46 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $891.25 Typical High $1,479.11 | Professional | None | $741.31 | $891.25 | $1,479.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $707.95 Median $2,290.87 Typical High $10,715.19 | Facility | None | $707.95 | $2,290.87 | $10,715.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $812.83 Median $1,288.25 Typical High $2,187.76 | Professional | None | $812.83 | $1,288.25 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $234.42 Typical High $363.08 | Professional | 80 · Assistant surgeon | $147.91 | $234.42 | $363.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $194.98 Typical High $309.03 | Professional | AS · PA/NP assist | $128.82 | $194.98 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $549.54 Typical High $2,398.83 | Facility | None | $457.09 | $549.54 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,479.11 Typical High $2,511.89 | Professional | None | $933.25 | $1,479.11 | $2,511.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $831.76 Median $1,000.00 Typical High $1,905.46 | Professional | None | $831.76 | $1,000.00 | $1,905.46 |
United Setting Facility Modifier None Typical Low $371.54 Median $645.65 Typical High $3,981.07 | Facility | None | $371.54 | $645.65 | $3,981.07 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,318.26 Typical High $2,137.96 | Professional | None | $912.01 | $1,318.26 | $2,137.96 |
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 $371.54 Median $371.54 Typical High $512.86 | Professional | 52 · Reduced service | $371.54 | $371.54 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $204.17 | Professional | 53 · Discontinued | $151.36 | $151.36 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $758.58 | Professional | 54 · Surgery only | $562.34 | $562.34 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $151.36 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $102.33 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $707.95 |
Where Georgia sits
The same service costs 6.3 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· 20th of 51
$1,288
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.