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 $2,238.72 Median $5,370.32 Typical High $7,943.28 | Facility | None | $2,238.72 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,691.53 | Professional | None | $2,238.72 | $2,238.72 | $2,691.53 |
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 $2,089.30 Median $3,090.30 Typical High $5,370.32 | Professional | None | $2,089.30 | $3,090.30 | $5,370.32 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,412.54 Median $1,995.26 Typical High $3,467.37 | Professional | 62 · Two surgeons | $1,412.54 | $1,995.26 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $354.81 Median $549.54 Typical High $912.01 | Professional | 80 · Assistant surgeon | $354.81 | $549.54 | $912.01 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $309.03 Median $436.52 Typical High $776.25 | Professional | AS · PA/NP assist | $309.03 | $436.52 | $776.25 |
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 $2,570.40 Median $3,715.35 Typical High $6,760.83 | Professional | None | $2,570.40 | $3,715.35 | $6,760.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,238.72 Median $2,754.23 Typical High $5,495.41 | Professional | None | $2,238.72 | $2,754.23 | $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 $2,187.76 Median $3,235.94 Typical High $6,918.31 | Professional | None | $2,187.76 | $3,235.94 | $6,918.31 |
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 $1,122.02 Median $1,122.02 Typical High $1,288.25 | Professional | 52 · Reduced service | $1,122.02 | $1,122.02 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $446.68 Typical High $524.81 | Professional | 53 · Discontinued | $446.68 | $446.68 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $1,659.59 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,659.59 | $1,659.59 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $331.13 Typical High $389.05 | Professional | 55 · Aftercare only | $331.13 | $331.13 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $223.87 Typical High $257.04 | Professional | 56 · Pre-op care only | $223.87 | $223.87 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,548.82 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,548.82 | $1,819.70 |
Where Georgia sits
The same service costs 7.2 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· 20th of 51
$3,090
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.