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 $707.95 Median $707.95 Typical High $1,258.93 | Professional | None | $707.95 | $707.95 | $1,258.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $467.74 Median $707.95 Typical High $1,737.80 | Facility | None | $467.74 | $707.95 | $1,737.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $676.08 Median $977.24 Typical High $1,737.80 | Professional | None | $676.08 | $977.24 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $426.58 Median $676.08 Typical High $1,096.48 | Professional | 62 · Two surgeons | $426.58 | $676.08 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $109.65 Median $186.21 Typical High $288.40 | Professional | 80 · Assistant surgeon | $109.65 | $186.21 | $288.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $95.50 Median $147.91 Typical High $245.47 | Professional | AS · PA/NP assist | $95.50 | $147.91 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $616.60 Typical High $3,235.94 | Facility | None | $446.68 | $616.60 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,174.90 Typical High $2,041.74 | Professional | None | $812.83 | $1,174.90 | $2,041.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $794.33 Typical High $1,778.28 | Professional | None | $676.08 | $794.33 | $1,778.28 |
Oscar Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,230.27 | $1,230.27 | $1,230.27 |
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 $616.60 Median $1,047.13 Typical High $1,905.46 | Professional | None | $616.60 | $1,047.13 | $1,905.46 |
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 $354.81 Median $354.81 Typical High $416.87 | Professional | 52 · Reduced service | $354.81 | $354.81 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $141.25 Typical High $165.96 | Professional | 53 · Discontinued | $141.25 | $141.25 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $616.60 | Professional | 54 · Surgery only | $524.81 | $524.81 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $123.03 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $83.18 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $83.18 |
Where Georgia sits
The same service costs 4.7 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
$955
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.