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 $363.08 Median $5,011.87 Typical High $10,000.00 | Facility | None | $363.08 | $5,011.87 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $363.08 Typical High $912.01 | Professional | None | $275.42 | $363.08 | $912.01 |
Ambetter Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
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 $295.12 Median $467.74 Typical High $794.33 | Professional | None | $295.12 | $467.74 | $794.33 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $54.95 Median $87.10 Typical High $144.54 | Professional | 80 · Assistant surgeon | $54.95 | $87.10 | $144.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $47.86 Median $72.44 Typical High $117.49 | Professional | AS · PA/NP assist | $47.86 | $72.44 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $549.54 Typical High $2,398.83 | Facility | None | $501.19 | $549.54 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $549.54 Typical High $933.25 | Professional | None | $338.84 | $549.54 | $933.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $309.03 Median $389.05 Typical High $758.58 | Professional | None | $309.03 | $389.05 | $758.58 |
United Setting Facility Modifier None Typical Low $501.19 Median $724.44 Typical High $3,548.13 | Facility | None | $501.19 | $724.44 | $3,548.13 |
United Setting Professional Modifier None Typical Low $338.84 Median $489.78 Typical High $776.25 | Professional | None | $338.84 | $489.78 | $776.25 |
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 $138.04 Median $138.04 Typical High $186.21 | Professional | 52 · Reduced service | $138.04 | $138.04 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $54.95 Typical High $74.13 | Professional | 53 · Discontinued | $54.95 | $54.95 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $204.17 Typical High $281.84 | Professional | 54 · Surgery only | $204.17 | $204.17 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $40.74 Typical High $56.23 | Professional | 55 · Aftercare only | $40.74 | $40.74 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $27.54 Typical High $37.15 | Professional | 56 · Pre-op care only | $27.54 | $27.54 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $190.55 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $190.55 | $190.55 | $263.03 |
Where Georgia sits
The same service costs 5.8 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· 16th of 51
$550
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.