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 $3,548.13 Typical High $7,585.78 | Facility | None | $630.96 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $588.84 | Professional | None | $371.54 | $371.54 | $588.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $354.81 Median $549.54 Typical High $1,318.26 | Facility | None | $354.81 | $549.54 | $1,318.26 |
Anthem BCBS Setting Professional Modifier None Typical Low $338.84 Median $512.86 Typical High $912.01 | Professional | None | $338.84 | $512.86 | $912.01 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $66.07 Median $102.33 Typical High $154.88 | Professional | 80 · Assistant surgeon | $66.07 | $102.33 | $154.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $51.29 Median $75.86 Typical High $128.82 | Professional | AS · PA/NP assist | $51.29 | $75.86 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $512.86 Typical High $3,235.94 | Facility | None | $331.13 | $512.86 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $616.60 Typical High $1,096.48 | Professional | None | $426.58 | $616.60 | $1,096.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $354.81 Median $436.52 Typical High $977.24 | Professional | None | $354.81 | $436.52 | $977.24 |
Oscar Health Setting Professional Modifier None Typical Low $602.56 Median $660.69 Typical High $660.69 | Professional | None | $602.56 | $660.69 | $660.69 |
United Setting Facility Modifier None Typical Low $79.43 Median $158.49 Typical High $1,778.28 | Facility | None | $79.43 | $158.49 | $1,778.28 |
United Setting Professional Modifier None Typical Low $323.59 Median $562.34 Typical High $1,000.00 | Professional | None | $323.59 | $562.34 | $1,000.00 |
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 $186.21 Median $186.21 Typical High $218.78 | Professional | 52 · Reduced service | $186.21 | $186.21 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $74.13 Typical High $87.10 | Professional | 53 · Discontinued | $74.13 | $74.13 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $281.84 Typical High $331.13 | Professional | 54 · Surgery only | $281.84 | $281.84 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $56.23 Typical High $66.07 | Professional | 55 · Aftercare only | $56.23 | $56.23 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $37.15 Typical High $43.65 | Professional | 56 · Pre-op care only | $37.15 | $37.15 | $43.65 |
Where Georgia sits
The same service costs 4.9 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· 20th of 51
$513
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.