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 $331.13 Median $5,370.32 Typical High $7,585.78 | Facility | None | $331.13 | $5,370.32 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $467.74 Typical High $588.84 | Professional | None | $331.13 | $467.74 | $588.84 |
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 $239.88 Median $407.38 Typical High $562.34 | Professional | None | $239.88 | $407.38 | $562.34 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $436.52 Median $602.56 Typical High $891.25 | Professional | 50 · Both sides | $436.52 | $602.56 | $891.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $181.97 Median $257.04 Typical High $389.05 | Professional | 62 · Two surgeons | $181.97 | $257.04 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $1,318.26 Typical High $1,737.80 | Facility | None | $812.83 | $1,318.26 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $549.54 Typical High $1,023.29 | Professional | None | $309.03 | $549.54 | $1,023.29 |
Kaiser Permanente Setting Professional Modifier None Typical Low $323.59 Median $549.54 Typical High $891.25 | Professional | None | $323.59 | $549.54 | $891.25 |
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 $302.00 Median $537.03 Typical High $1,000.00 | Professional | None | $302.00 | $537.03 | $1,000.00 |
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 $165.96 Median $204.17 Typical High $288.40 | Professional | 52 · Reduced service | $165.96 | $204.17 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $87.10 Typical High $114.82 | Professional | 53 · Discontinued | $66.07 | $87.10 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $323.59 Typical High $436.52 | Professional | 54 · Surgery only | $245.47 | $323.59 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $61.66 Typical High $87.10 | Professional | 55 · Aftercare only | $48.98 | $61.66 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $40.74 Typical High $57.54 | Professional | 56 · Pre-op care only | $33.11 | $40.74 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $302.00 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $229.09 | $302.00 | $407.38 |
Where Georgia sits
The same service costs 5.5 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· 33rd of 51
$457
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.