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 $630.96 Median $3,630.78 Typical High $7,943.28 | Facility | None | $630.96 | $3,630.78 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $794.33 | Professional | None | $630.96 | $630.96 | $794.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,090.30 Median $7,943.28 Typical High $7,943.28 | Facility | None | $3,090.30 | $7,943.28 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $602.56 Median $933.25 Typical High $1,318.26 | Professional | None | $602.56 | $933.25 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $912.01 Median $1,445.44 Typical High $1,949.84 | Professional | 50 · Both sides | $912.01 | $1,445.44 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $389.05 Median $602.56 Typical High $831.76 | Professional | 62 · Two surgeons | $389.05 | $602.56 | $831.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $97.72 Median $154.88 Typical High $208.93 | Professional | 80 · Assistant surgeon | $97.72 | $154.88 | $208.93 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $85.11 Median $134.90 Typical High $186.21 | Professional | AS · PA/NP assist | $85.11 | $134.90 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $1,862.09 Typical High $6,760.83 | Facility | None | $1,318.26 | $1,862.09 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $851.14 Typical High $1,698.24 | Professional | None | $645.65 | $851.14 | $1,698.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $645.65 Median $1,000.00 Typical High $2,187.76 | Professional | None | $645.65 | $1,000.00 | $2,187.76 |
Oscar Health Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,187.76 Typical High $7,943.28 | Facility | None | $1,000.00 | $2,187.76 | $7,943.28 |
United Setting Professional Modifier None Typical Low $257.04 Median $457.09 Typical High $794.33 | Professional | None | $257.04 | $457.09 | $794.33 |
5 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 $316.23 Median $316.23 Typical High $363.08 | Professional | 52 · Reduced service | $316.23 | $316.23 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $144.54 | Professional | 53 · Discontinued | $125.89 | $125.89 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $467.74 Typical High $537.03 | Professional | 54 · Surgery only | $467.74 | $467.74 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $107.15 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $72.44 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $72.44 |
Where Georgia sits
The same service costs 10.0 times more in Alaska than in Kentucky. 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· 11th of 51
$851
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.