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 $831.76 Median $5,011.87 Typical High $7,943.28 | Facility | None | $831.76 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $724.44 | Professional | None | $478.63 | $478.63 | $724.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $512.86 Median $1,000.00 Typical High $4,570.88 | Facility | None | $512.86 | $1,000.00 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $398.11 Median $630.96 Typical High $1,122.02 | Professional | None | $398.11 | $630.96 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $676.08 Median $1,023.29 Typical High $1,698.24 | Professional | 50 · Both sides | $676.08 | $1,023.29 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $72.44 Median $114.82 Typical High $190.55 | Professional | 80 · Assistant surgeon | $72.44 | $114.82 | $190.55 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $63.10 Median $95.50 Typical High $158.49 | Professional | AS · PA/NP assist | $63.10 | $95.50 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,096.48 Typical High $1,445.44 | Facility | None | $524.81 | $1,096.48 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $741.31 Typical High $1,318.26 | Professional | None | $562.34 | $741.31 | $1,318.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $489.78 Median $575.44 Typical High $1,230.27 | Professional | None | $489.78 | $575.44 | $1,230.27 |
Oscar Health Setting Professional Modifier None Typical Low $812.83 Median $831.76 Typical High $831.76 | Professional | None | $812.83 | $831.76 | $831.76 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,479.11 Typical High $5,128.61 | Facility | None | $851.14 | $1,479.11 | $5,128.61 |
United Setting Professional Modifier None Typical Low $407.38 Median $691.83 Typical High $1,288.25 | Professional | None | $407.38 | $691.83 | $1,288.25 |
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 $239.88 Median $239.88 Typical High $275.42 | Professional | 52 · Reduced service | $239.88 | $239.88 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $95.50 Typical High $109.65 | Professional | 53 · Discontinued | $95.50 | $95.50 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $363.08 Typical High $416.87 | Professional | 54 · Surgery only | $363.08 | $363.08 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $83.18 | Professional | 55 · Aftercare only | $72.44 | $72.44 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $47.86 Typical High $54.95 | Professional | 56 · Pre-op care only | $47.86 | $47.86 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $338.84 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $338.84 | $338.84 | $389.05 |
Where Georgia sits
The same service costs 5.8 times more in Alaska than in Utah. 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· 22nd of 51
$676
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.