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 $1,949.84 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,949.84 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $2,344.23 | Professional | None | $1,949.84 | $1,949.84 | $2,344.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,122.02 Median $3,162.28 Typical High $16,218.10 | Facility | None | $1,122.02 | $3,162.28 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,819.70 Median $2,691.53 Typical High $4,570.88 | Professional | None | $1,819.70 | $2,691.53 | $4,570.88 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $302.00 Median $467.74 Typical High $758.58 | Professional | 80 · Assistant surgeon | $302.00 | $467.74 | $758.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $269.15 Median $380.19 Typical High $616.60 | Professional | AS · PA/NP assist | $269.15 | $380.19 | $616.60 |
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 $2,238.72 Median $3,235.94 Typical High $5,888.44 | Professional | None | $2,238.72 | $3,235.94 | $5,888.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,949.84 Median $2,398.83 Typical High $4,677.35 | Professional | None | $1,949.84 | $2,398.83 | $4,677.35 |
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 $1,905.46 Median $2,754.23 Typical High $6,025.60 | Professional | None | $1,905.46 | $2,754.23 | $6,025.60 |
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 $977.24 Median $977.24 Typical High $1,122.02 | Professional | 52 · Reduced service | $977.24 | $977.24 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $389.05 Typical High $457.09 | Professional | 53 · Discontinued | $389.05 | $389.05 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,445.44 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,445.44 | $1,445.44 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $288.40 Typical High $338.84 | Professional | 55 · Aftercare only | $288.40 | $288.40 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $194.98 Typical High $223.87 | Professional | 56 · Pre-op care only | $194.98 | $194.98 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,348.96 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,348.96 | $1,584.89 |
Where Georgia sits
The same service costs 5.9 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· 18th of 51
$2,692
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.