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 $1,584.89 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,584.89 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,949.84 | Professional | None | $1,584.89 | $1,584.89 | $1,949.84 |
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 $1,548.82 Median $2,238.72 Typical High $3,890.45 | Professional | None | $1,548.82 | $2,238.72 | $3,890.45 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $257.04 Median $389.05 Typical High $660.69 | Professional | 80 · Assistant surgeon | $257.04 | $389.05 | $660.69 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $223.87 Median $316.23 Typical High $549.54 | Professional | AS · PA/NP assist | $223.87 | $316.23 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $549.54 Typical High $2,398.83 | Facility | None | $457.09 | $549.54 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $2,511.89 Typical High $4,897.79 | Professional | None | $1,862.09 | $2,511.89 | $4,897.79 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,584.89 Median $1,995.26 Typical High $3,090.30 | Professional | None | $1,584.89 | $1,995.26 | $3,090.30 |
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 $1,584.89 Median $2,290.87 Typical High $4,897.79 | Professional | None | $1,584.89 | $2,290.87 | $4,897.79 |
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 $794.33 Median $794.33 Typical High $933.25 | Professional | 52 · Reduced service | $794.33 | $794.33 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $316.23 Typical High $371.54 | Professional | 53 · Discontinued | $316.23 | $316.23 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,202.26 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,202.26 | $1,202.26 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $239.88 Typical High $281.84 | Professional | 55 · Aftercare only | $239.88 | $239.88 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $158.49 Typical High $186.21 | Professional | 56 · Pre-op care only | $158.49 | $158.49 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,122.02 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,122.02 | $1,318.26 |
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· 18th of 51
$2,239
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.