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 $2,454.71 Median $5,370.32 Typical High $7,943.28 | Facility | None | $2,454.71 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $2,454.71 Median $2,511.89 Typical High $4,365.16 | Professional | None | $2,454.71 | $2,511.89 | $4,365.16 |
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 $2,187.76 Median $3,467.37 Typical High $5,370.32 | Professional | None | $2,187.76 | $3,467.37 | $5,370.32 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,548.82 Median $2,238.72 Typical High $3,715.35 | Professional | 62 · Two surgeons | $1,548.82 | $2,238.72 | $3,715.35 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $389.05 Median $602.56 Typical High $954.99 | Professional | 80 · Assistant surgeon | $389.05 | $602.56 | $954.99 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $346.74 Median $489.78 Typical High $812.83 | Professional | AS · PA/NP assist | $346.74 | $489.78 | $812.83 |
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 $2,630.27 Median $3,890.45 Typical High $7,413.10 | Professional | None | $2,630.27 | $3,890.45 | $7,413.10 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,454.71 Median $3,090.30 Typical High $5,623.41 | Professional | None | $2,454.71 | $3,090.30 | $5,623.41 |
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 $2,344.23 Median $3,467.37 Typical High $7,585.78 | Professional | None | $2,344.23 | $3,467.37 | $7,585.78 |
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 $1,230.27 Median $1,230.27 Typical High $1,412.54 | Professional | 52 · Reduced service | $1,230.27 | $1,230.27 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $489.78 Typical High $575.44 | Professional | 53 · Discontinued | $489.78 | $489.78 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $1,819.70 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,819.70 | $1,819.70 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $363.08 Typical High $426.58 | Professional | 55 · Aftercare only | $363.08 | $363.08 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $245.47 Typical High $288.40 | Professional | 56 · Pre-op care only | $245.47 | $245.47 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $1,698.24 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,698.24 | $1,698.24 | $1,995.26 |
Where Georgia sits
The same service costs 6.0 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
$3,388
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.