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 $436.52 Median $5,370.32 Typical High $7,943.28 | Facility | None | $436.52 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $436.52 Typical High $831.76 | Professional | None | $407.38 | $436.52 | $831.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,621.81 Typical High $7,244.36 | Facility | None | $524.81 | $1,621.81 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $436.52 Median $645.65 Typical High $1,096.48 | Professional | None | $436.52 | $645.65 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $302.00 Median $416.87 Typical High $724.44 | Professional | 62 · Two surgeons | $302.00 | $416.87 | $724.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $77.62 Median $102.33 Typical High $190.55 | Professional | 80 · Assistant surgeon | $77.62 | $102.33 | $190.55 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $67.61 Median $93.33 Typical High $162.18 | Professional | AS · PA/NP assist | $67.61 | $93.33 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $831.76 Typical High $4,265.80 | Facility | None | $512.86 | $831.76 | $4,265.80 |
Cigna 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 |
Kaiser Permanente Setting Professional Modifier None Typical Low $446.68 Median $537.03 Typical High $1,071.52 | Professional | None | $446.68 | $537.03 | $1,071.52 |
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 $512.86 Median $741.31 Typical High $1,148.15 | Professional | None | $512.86 | $741.31 | $1,148.15 |
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 $204.17 Median $213.80 Typical High $263.03 | Professional | 52 · Reduced service | $204.17 | $213.80 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $87.10 Typical High $107.15 | Professional | 53 · Discontinued | $81.28 | $87.10 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $323.59 Typical High $398.11 | Professional | 54 · Surgery only | $309.03 | $323.59 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $64.57 Typical High $79.43 | Professional | 55 · Aftercare only | $61.66 | $64.57 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $43.65 Typical High $53.70 | Professional | 56 · Pre-op care only | $40.74 | $43.65 | $53.70 |
Where Georgia sits
The same service costs 3.4 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· 22nd of 51
$676
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.