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 $354.81 Median $446.68 Typical High $1,122.02 | Professional | None | $354.81 | $446.68 | $1,122.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $562.34 Median $1,071.52 Typical High $4,570.88 | Facility | None | $562.34 | $1,071.52 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $380.19 Median $616.60 Typical High $1,071.52 | Professional | None | $380.19 | $616.60 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $281.84 Median $398.11 Typical High $724.44 | Professional | 62 · Two surgeons | $281.84 | $398.11 | $724.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $70.79 Median $112.20 Typical High $186.21 | Professional | 80 · Assistant surgeon | $70.79 | $112.20 | $186.21 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $61.66 Median $89.13 Typical High $158.49 | Professional | AS · PA/NP assist | $61.66 | $89.13 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,995.26 Typical High $2,630.27 | Facility | None | $602.56 | $1,995.26 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $707.95 Typical High $1,202.26 | Professional | None | $426.58 | $707.95 | $1,202.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $398.11 Median $501.19 Typical High $1,412.54 | Professional | None | $398.11 | $501.19 | $1,412.54 |
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 $426.58 Median $602.56 Typical High $1,000.00 | Professional | None | $426.58 | $602.56 | $1,000.00 |
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 $177.83 Median $177.83 Typical High $239.88 | Professional | 52 · Reduced service | $177.83 | $177.83 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $70.79 Typical High $97.72 | Professional | 53 · Discontinued | $70.79 | $70.79 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $269.15 Typical High $363.08 | Professional | 54 · Surgery only | $269.15 | $269.15 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $53.70 Typical High $72.44 | Professional | 55 · Aftercare only | $53.70 | $53.70 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $35.48 Typical High $47.86 | Professional | 56 · Pre-op care only | $35.48 | $35.48 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $251.19 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $251.19 | $251.19 | $338.84 |
Where Georgia sits
The same service costs 7.1 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· 23rd of 51
$692
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.