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 $812.83 Median $5,370.32 Typical High $7,943.28 | Facility | None | $812.83 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $812.83 Typical High $1,071.52 | Professional | None | $758.58 | $812.83 | $1,071.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $707.95 Median $2,290.87 Typical High $10,715.19 | Facility | None | $707.95 | $2,290.87 | $10,715.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $776.25 Median $1,258.93 Typical High $2,041.74 | Professional | None | $776.25 | $1,258.93 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $199.53 Typical High $363.08 | Professional | 80 · Assistant surgeon | $151.36 | $199.53 | $363.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $177.83 Typical High $295.12 | Professional | AS · PA/NP assist | $128.82 | $177.83 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $549.54 Typical High $2,398.83 | Facility | None | $457.09 | $549.54 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,318.26 Typical High $2,344.23 | Professional | None | $891.25 | $1,318.26 | $2,344.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $851.14 Median $1,071.52 Typical High $1,995.26 | Professional | None | $851.14 | $1,071.52 | $1,995.26 |
United Setting Facility Modifier None Typical Low $371.54 Median $645.65 Typical High $3,981.07 | Facility | None | $371.54 | $645.65 | $3,981.07 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,318.26 Typical High $2,089.30 | Professional | None | $891.25 | $1,318.26 | $2,089.30 |
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 $380.19 Median $407.38 Typical High $489.78 | Professional | 52 · Reduced service | $380.19 | $407.38 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $162.18 Typical High $194.98 | Professional | 53 · Discontinued | $151.36 | $162.18 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $602.56 Typical High $724.44 | Professional | 54 · Surgery only | $575.44 | $602.56 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $123.03 Typical High $144.54 | Professional | 55 · Aftercare only | $114.82 | $123.03 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $81.28 Typical High $97.72 | Professional | 56 · Pre-op care only | $75.86 | $81.28 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $562.34 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $537.03 | $562.34 | $676.08 |
Where Georgia sits
The same service costs 6.6 times more in Alaska 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· 15th of 51
$1,259
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.