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 $1,202.26 Median $5,370.32 Typical High $8,317.64 | Facility | None | $1,202.26 | $5,370.32 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $575.44 Typical High $1,584.89 | Professional | None | $562.34 | $575.44 | $1,584.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $691.83 Median $1,412.54 Typical High $8,511.38 | Facility | None | $691.83 | $1,412.54 | $8,511.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $512.86 Median $831.76 Typical High $1,288.25 | Professional | None | $512.86 | $831.76 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $371.54 Median $524.81 Typical High $812.83 | Professional | 62 · Two surgeons | $371.54 | $524.81 | $812.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $95.50 Median $138.04 Typical High $213.80 | Professional | 80 · Assistant surgeon | $95.50 | $138.04 | $213.80 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $83.18 Median $117.49 Typical High $181.97 | Professional | AS · PA/NP assist | $83.18 | $117.49 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $3,388.44 Typical High $4,365.16 | Facility | None | $741.31 | $3,388.44 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $977.24 Typical High $1,659.59 | Professional | None | $676.08 | $977.24 | $1,659.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $537.03 Median $645.65 Typical High $1,148.15 | Professional | None | $537.03 | $645.65 | $1,148.15 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $3,715.35 Typical High $9,549.93 | Facility | None | $1,513.56 | $3,715.35 | $9,549.93 |
United Setting Professional Modifier None Typical Low $602.56 Median $870.96 Typical High $1,479.11 | Professional | None | $602.56 | $870.96 | $1,479.11 |
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 $281.84 Median $288.40 Typical High $323.59 | Professional | 52 · Reduced service | $281.84 | $288.40 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $114.82 Typical High $128.82 | Professional | 53 · Discontinued | $114.82 | $114.82 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $489.78 | Professional | 54 · Surgery only | $426.58 | $426.58 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $87.10 Typical High $97.72 | Professional | 55 · Aftercare only | $85.11 | $87.10 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $57.54 Typical High $64.57 | Professional | 56 · Pre-op care only | $56.23 | $57.54 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $398.11 | $398.11 | $457.09 |
Where Georgia sits
The same service costs 8.1 times more in Oklahoma 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· 28th of 51
$871
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.