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 $407.38 Median $5,011.87 Typical High $10,000.00 | Facility | None | $407.38 | $5,011.87 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $398.11 Typical High $1,000.00 | Professional | None | $302.00 | $398.11 | $1,000.00 |
Ambetter Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | None | $630.96 | $630.96 | $630.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $1,288.25 Typical High $4,570.88 | Facility | None | $724.44 | $1,288.25 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $331.13 Median $524.81 Typical High $870.96 | Professional | None | $331.13 | $524.81 | $870.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $239.88 Median $354.81 Typical High $562.34 | Professional | 62 · Two surgeons | $239.88 | $354.81 | $562.34 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $60.26 Median $95.50 Typical High $147.91 | Professional | 80 · Assistant surgeon | $60.26 | $95.50 | $147.91 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $52.48 Median $79.43 Typical High $125.89 | Professional | AS · PA/NP assist | $52.48 | $79.43 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $1,995.26 Typical High $2,754.23 | Facility | None | $812.83 | $1,995.26 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $616.60 Typical High $1,023.29 | Professional | None | $371.54 | $616.60 | $1,023.29 |
Kaiser Permanente Setting Professional Modifier None Typical Low $338.84 Median $407.38 Typical High $851.14 | Professional | None | $338.84 | $407.38 | $851.14 |
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 $380.19 Median $549.54 Typical High $870.96 | Professional | None | $380.19 | $549.54 | $870.96 |
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 $151.36 Median $151.36 Typical High $204.17 | Professional | 52 · Reduced service | $151.36 | $151.36 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $60.26 Typical High $81.28 | Professional | 53 · Discontinued | $60.26 | $60.26 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $229.09 Typical High $309.03 | Professional | 54 · Surgery only | $229.09 | $229.09 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $45.71 Typical High $61.66 | Professional | 55 · Aftercare only | $45.71 | $45.71 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $30.20 Typical High $40.74 | Professional | 56 · Pre-op care only | $30.20 | $30.20 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $213.80 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $213.80 | $213.80 | $288.40 |
Where Georgia sits
The same service costs 7.1 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
$617
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.