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 $1,513.56 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,513.56 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,862.09 | Professional | None | $1,513.56 | $1,513.56 | $1,862.09 |
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 $1,258.93 Median $2,137.96 Typical High $3,235.94 | Professional | None | $1,258.93 | $2,137.96 | $3,235.94 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $912.01 Median $1,348.96 Typical High $2,137.96 | Professional | 62 · Two surgeons | $912.01 | $1,348.96 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $229.09 Median $338.84 Typical High $588.84 | Professional | 80 · Assistant surgeon | $229.09 | $338.84 | $588.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $295.12 Typical High $467.74 | Professional | AS · PA/NP assist | $204.17 | $295.12 | $467.74 |
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 $1,513.56 Median $2,511.89 Typical High $4,570.88 | Professional | None | $1,513.56 | $2,511.89 | $4,570.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,548.82 Median $1,905.46 Typical High $3,715.35 | Professional | None | $1,548.82 | $1,905.46 | $3,715.35 |
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 $1,288.25 Median $1,905.46 Typical High $4,677.35 | Professional | None | $1,288.25 | $1,905.46 | $4,677.35 |
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 $758.58 Median $758.58 Typical High $891.25 | Professional | 52 · Reduced service | $758.58 | $758.58 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $302.00 Typical High $354.81 | Professional | 53 · Discontinued | $302.00 | $302.00 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,148.15 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,148.15 | $1,148.15 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $229.09 Typical High $263.03 | Professional | 55 · Aftercare only | $229.09 | $229.09 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $151.36 Typical High $177.83 | Professional | 56 · Pre-op care only | $151.36 | $151.36 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,071.52 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,071.52 | $1,230.27 |
Where Georgia sits
The same service costs 8.5 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
$2,089
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.