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 $977.24 Median $5,370.32 Typical High $7,943.28 | Facility | None | $977.24 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $1,513.56 Typical High $1,905.46 | Professional | None | $371.54 | $1,513.56 | $1,905.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,000.00 Median $1,862.09 Typical High $7,244.36 | Facility | None | $1,000.00 | $1,862.09 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $524.81 Median $1,621.81 Typical High $4,168.69 | Professional | None | $524.81 | $1,621.81 | $4,168.69 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $371.54 Median $1,023.29 Typical High $2,754.23 | Professional | 62 · Two surgeons | $371.54 | $1,023.29 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $3,467.37 Typical High $4,786.30 | Facility | None | $1,445.44 | $3,467.37 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $1,479.11 Typical High $3,715.35 | Professional | None | $446.68 | $1,479.11 | $3,715.35 |
Kaiser Permanente Setting Professional Modifier None Typical Low $457.09 Median $1,621.81 Typical High $3,090.30 | Professional | None | $457.09 | $1,621.81 | $3,090.30 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,019.95 Typical High $8,709.64 | Facility | None | $1,258.93 | $3,019.95 | $8,709.64 |
United Setting Professional Modifier None Typical Low $467.74 Median $1,862.09 Typical High $3,801.89 | Professional | None | $467.74 | $1,862.09 | $3,801.89 |
4 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 54 · Surgery only Typical Low $281.84 Median $1,122.02 Typical High $1,412.54 | Professional | 54 · Surgery only | $281.84 | $1,122.02 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $229.09 Typical High $281.84 | Professional | 55 · Aftercare only | $56.23 | $229.09 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $151.36 Typical High $190.55 | Professional | 56 · Pre-op care only | $37.15 | $151.36 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $1,047.13 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $263.03 | $1,047.13 | $1,318.26 |
Where Georgia sits
The same service costs 4.5 times more in Alaska than in Nebraska. 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· 27th of 51
$1,738
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.