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 $2,570.40 Median $5,370.32 Typical High $7,943.28 | Facility | None | $2,570.40 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $3,090.30 | Professional | None | $2,570.40 | $2,570.40 | $3,090.30 |
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 $2,344.23 Median $3,548.13 Typical High $6,165.95 | Professional | None | $2,344.23 | $3,548.13 | $6,165.95 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,584.89 Median $2,238.72 Typical High $3,890.45 | Professional | 62 · Two surgeons | $1,584.89 | $2,238.72 | $3,890.45 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $407.38 Median $616.60 Typical High $1,047.13 | Professional | 80 · Assistant surgeon | $407.38 | $616.60 | $1,047.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $354.81 Median $501.19 Typical High $870.96 | Professional | AS · PA/NP assist | $354.81 | $501.19 | $870.96 |
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 $2,691.53 Median $4,168.69 Typical High $7,762.47 | Professional | None | $2,691.53 | $4,168.69 | $7,762.47 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,511.89 Median $3,162.28 Typical High $5,495.41 | Professional | None | $2,511.89 | $3,162.28 | $5,495.41 |
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 $2,454.71 Median $3,630.78 Typical High $7,943.28 | Professional | None | $2,454.71 | $3,630.78 | $7,943.28 |
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 $1,288.25 Median $1,288.25 Typical High $1,479.11 | Professional | 52 · Reduced service | $1,288.25 | $1,288.25 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $512.86 Typical High $602.56 | Professional | 53 · Discontinued | $512.86 | $512.86 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $1,905.46 Typical High $2,238.72 | Professional | 54 · Surgery only | $1,905.46 | $1,905.46 | $2,238.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $380.19 Typical High $446.68 | Professional | 55 · Aftercare only | $380.19 | $380.19 | $446.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $257.04 Typical High $302.00 | Professional | 56 · Pre-op care only | $257.04 | $257.04 | $302.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $1,778.28 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $1,778.28 | $1,778.28 | $2,089.30 |
Where Georgia sits
The same service costs 10.0 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
$3,548
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.