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 $1,778.28 Median $7,079.46 Typical High $15,488.17 | Facility | None | $1,778.28 | $7,079.46 | $15,488.17 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $776.25 Typical High $3,235.94 | Professional | None | $602.56 | $776.25 | $3,235.94 |
Anthem BCBS Setting Facility Modifier None Typical Low $794.33 Median $1,513.56 Typical High $8,912.51 | Facility | None | $794.33 | $1,513.56 | $8,912.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $645.65 Median $1,096.48 Typical High $1,862.09 | Professional | None | $645.65 | $1,096.48 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,174.90 Median $1,778.28 Typical High $2,951.21 | Professional | 50 · Both sides | $1,174.90 | $1,778.28 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $199.53 Typical High $309.03 | Professional | 80 · Assistant surgeon | $120.23 | $199.53 | $309.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $109.65 Median $165.96 Typical High $275.42 | Professional | AS · PA/NP assist | $109.65 | $165.96 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $3,548.13 Typical High $4,677.35 | Facility | None | $831.76 | $3,548.13 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $1,202.26 Typical High $1,995.26 | Professional | None | $758.58 | $1,202.26 | $1,995.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $660.69 Median $831.76 Typical High $3,090.30 | Professional | None | $660.69 | $831.76 | $3,090.30 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $3,715.35 Typical High $9,549.93 | Facility | None | $1,513.56 | $3,715.35 | $9,549.93 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,122.02 Typical High $1,737.80 | Professional | None | $776.25 | $1,122.02 | $1,737.80 |
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 $302.00 Median $302.00 Typical High $407.38 | Professional | 52 · Reduced service | $302.00 | $302.00 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $120.23 Typical High $162.18 | Professional | 53 · Discontinued | $120.23 | $120.23 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $446.68 Typical High $602.56 | Professional | 54 · Surgery only | $446.68 | $446.68 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $89.13 Typical High $123.03 | Professional | 55 · Aftercare only | $89.13 | $89.13 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $60.26 Typical High $81.28 | Professional | 56 · Pre-op care only | $60.26 | $60.26 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $416.87 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $416.87 | $416.87 | $575.44 |
Where Georgia sits
The same service costs 6.5 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
$1,230
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.