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 $478.63 Median $3,630.78 Typical High $7,943.28 | Facility | None | $478.63 | $3,630.78 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $467.74 Typical High $1,445.44 | Professional | None | $446.68 | $467.74 | $1,445.44 |
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 $467.74 Median $724.44 Typical High $1,148.15 | Professional | None | $467.74 | $724.44 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $83.18 Median $117.49 Typical High $204.17 | Professional | 80 · Assistant surgeon | $83.18 | $117.49 | $204.17 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $72.44 Median $102.33 Typical High $169.82 | Professional | AS · PA/NP assist | $72.44 | $102.33 | $169.82 |
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 $524.81 Median $707.95 Typical High $1,348.96 | Professional | None | $524.81 | $707.95 | $1,348.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $478.63 Median $575.44 Typical High $1,230.27 | Professional | None | $478.63 | $575.44 | $1,230.27 |
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 $489.78 Median $741.31 Typical High $1,230.27 | Professional | None | $489.78 | $741.31 | $1,230.27 |
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 $223.87 Median $234.42 Typical High $288.40 | Professional | 52 · Reduced service | $223.87 | $234.42 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $93.33 Typical High $114.82 | Professional | 53 · Discontinued | $89.13 | $93.33 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $346.74 Typical High $426.58 | Professional | 54 · Surgery only | $331.13 | $346.74 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $70.79 Typical High $85.11 | Professional | 55 · Aftercare only | $66.07 | $70.79 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $46.77 Typical High $57.54 | Professional | 56 · Pre-op care only | $44.67 | $46.77 | $57.54 |
Where Georgia sits
The same service costs 3.2 times more in Alaska than in Arkansas. 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· 17th 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.