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 $467.74 Median $5,370.32 Typical High $10,000.00 | Facility | None | $467.74 | $5,370.32 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $446.68 Typical High $1,174.90 | Professional | None | $346.74 | $446.68 | $1,174.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $660.69 Median $1,202.26 Typical High $4,570.88 | Facility | None | $660.69 | $1,202.26 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $371.54 Median $602.56 Typical High $1,000.00 | Professional | None | $371.54 | $602.56 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $275.42 Median $380.19 Typical High $660.69 | Professional | 62 · Two surgeons | $275.42 | $380.19 | $660.69 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $74.13 Median $109.65 Typical High $181.97 | Professional | 80 · Assistant surgeon | $74.13 | $109.65 | $181.97 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $61.66 Median $85.11 Typical High $141.25 | Professional | AS · PA/NP assist | $61.66 | $85.11 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,089.30 Typical High $2,691.53 | Facility | None | $602.56 | $2,089.30 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $691.83 Typical High $1,174.90 | Professional | None | $416.87 | $691.83 | $1,174.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $389.05 Median $467.74 Typical High $977.24 | Professional | None | $389.05 | $467.74 | $977.24 |
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 $416.87 Median $588.84 Typical High $977.24 | Professional | None | $416.87 | $588.84 | $977.24 |
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 $173.78 Median $173.78 Typical High $234.42 | Professional | 52 · Reduced service | $173.78 | $173.78 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $69.18 Typical High $95.50 | Professional | 53 · Discontinued | $69.18 | $69.18 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $263.03 Typical High $354.81 | Professional | 54 · Surgery only | $263.03 | $263.03 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $52.48 Typical High $70.79 | Professional | 55 · Aftercare only | $52.48 | $52.48 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $34.67 Typical High $47.86 | Professional | 56 · Pre-op care only | $34.67 | $34.67 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $245.47 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $245.47 | $245.47 | $331.13 |
Where Georgia sits
The same service costs 10.2 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
$676
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.