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 $741.31 Median $5,623.41 Typical High $10,000.00 | Facility | None | $741.31 | $5,623.41 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $741.31 Typical High $1,122.02 | Professional | None | $691.83 | $741.31 | $1,122.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $812.83 Median $2,290.87 Typical High $10,715.19 | Facility | None | $812.83 | $2,290.87 | $10,715.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $707.95 Median $1,148.15 Typical High $1,862.09 | Professional | None | $707.95 | $1,148.15 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $524.81 Median $724.44 Typical High $1,202.26 | Professional | 62 · Two surgeons | $524.81 | $724.44 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $181.97 Typical High $316.23 | Professional | 80 · Assistant surgeon | $131.83 | $181.97 | $316.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $117.49 Median $162.18 Typical High $269.15 | Professional | AS · PA/NP assist | $117.49 | $162.18 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $549.54 Typical High $2,511.89 | Facility | None | $446.68 | $549.54 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,202.26 Typical High $2,089.30 | Professional | None | $794.33 | $1,202.26 | $2,089.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $758.58 Median $954.99 Typical High $1,445.44 | Professional | None | $758.58 | $954.99 | $1,445.44 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $7,585.78 | Facility | None | $954.99 | $1,995.26 | $7,585.78 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,202.26 Typical High $1,905.46 | Professional | None | $812.83 | $1,202.26 | $1,905.46 |
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 $346.74 Median $371.54 Typical High $436.52 | Professional | 52 · Reduced service | $346.74 | $371.54 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $147.91 Typical High $173.78 | Professional | 53 · Discontinued | $138.04 | $147.91 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $549.54 Typical High $660.69 | Professional | 54 · Surgery only | $512.86 | $549.54 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $109.65 Typical High $131.83 | Professional | 55 · Aftercare only | $104.71 | $109.65 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $74.13 Typical High $87.10 | Professional | 56 · Pre-op care only | $69.18 | $74.13 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $512.86 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $478.63 | $512.86 | $616.60 |
Where Georgia sits
The same service costs 8.5 times more in Oklahoma than in Texas. 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· 26th of 51
$1,148
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.