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 $1,202.26 Median $5,011.87 Typical High $7,943.28 | Facility | None | $1,202.26 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,445.44 | Professional | None | $1,148.15 | $1,148.15 | $1,445.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $512.86 Median $1,174.90 Typical High $7,244.36 | Facility | None | $512.86 | $1,174.90 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,548.82 Typical High $2,754.23 | Professional | None | $933.25 | $1,548.82 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $177.83 Median $288.40 Typical High $467.74 | Professional | 80 · Assistant surgeon | $177.83 | $288.40 | $467.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $223.87 Typical High $380.19 | Professional | AS · PA/NP assist | $154.88 | $223.87 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $2,454.71 Typical High $3,162.28 | Facility | None | $524.81 | $2,454.71 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,862.09 Typical High $3,235.94 | Professional | None | $1,288.25 | $1,862.09 | $3,235.94 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,148.15 Median $1,412.54 Typical High $2,570.40 | Professional | None | $1,148.15 | $1,412.54 | $2,570.40 |
Oscar Health Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | None | $2,041.74 | $2,041.74 | $2,041.74 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $2,884.03 Typical High $8,709.64 | Facility | None | $1,258.93 | $2,884.03 | $8,709.64 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,659.59 Typical High $3,090.30 | Professional | None | $1,000.00 | $1,659.59 | $3,090.30 |
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 $575.44 Median $575.44 Typical High $660.69 | Professional | 52 · Reduced service | $575.44 | $575.44 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $229.09 Typical High $269.15 | Professional | 53 · Discontinued | $229.09 | $229.09 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $870.96 Typical High $1,000.00 | Professional | 54 · Surgery only | $870.96 | $870.96 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $173.78 Typical High $199.53 | Professional | 55 · Aftercare only | $173.78 | $173.78 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $134.90 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $812.83 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $812.83 | $812.83 | $933.25 |
Where Georgia sits
The same service costs 6.2 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· 24th of 51
$1,585
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.