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 $208.93 Median $3,548.13 Typical High $7,585.78 | Facility | None | $208.93 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $208.93 Typical High $281.84 | Professional | None | $173.78 | $208.93 | $281.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $380.19 Median $776.25 Typical High $3,630.78 | Facility | None | $380.19 | $776.25 | $3,630.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $218.78 Median $363.08 Typical High $575.44 | Professional | None | $218.78 | $363.08 | $575.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $154.88 Median $229.09 Typical High $363.08 | Professional | 62 · Two surgeons | $154.88 | $229.09 | $363.08 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $38.90 Median $58.88 Typical High $93.33 | Professional | 80 · Assistant surgeon | $38.90 | $58.88 | $93.33 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $34.67 Median $50.12 Typical High $83.18 | Professional | AS · PA/NP assist | $34.67 | $50.12 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $223.87 Typical High $602.56 | Facility | None | $165.96 | $223.87 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $380.19 Typical High $676.08 | Professional | None | $218.78 | $380.19 | $676.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $208.93 Median $288.40 Typical High $524.81 | Professional | None | $208.93 | $288.40 | $524.81 |
United Setting Facility Modifier None Typical Low $79.43 Median $158.49 Typical High $1,778.28 | Facility | None | $79.43 | $158.49 | $1,778.28 |
United Setting Professional Modifier None Typical Low $223.87 Median $354.81 Typical High $562.34 | Professional | None | $223.87 | $354.81 | $562.34 |
5 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 $87.10 Median $104.71 Typical High $141.25 | Professional | 52 · Reduced service | $87.10 | $104.71 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $41.69 Typical High $56.23 | Professional | 53 · Discontinued | $34.67 | $41.69 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $158.49 Typical High $213.80 | Professional | 54 · Surgery only | $128.82 | $158.49 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $31.62 Typical High $42.66 | Professional | 55 · Aftercare only | $25.70 | $31.62 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $20.89 Typical High $28.18 | Professional | 56 · Pre-op care only | $17.38 | $20.89 | $28.18 |
Where Georgia sits
The same service costs 3.7 times more in Alaska than in Maryland. 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· 14th of 51
$363
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.