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 $1,479.11 Median $5,623.41 Typical High $9,549.93 | Facility | None | $1,479.11 | $5,623.41 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,584.89 Typical High $3,311.31 | Professional | None | $1,445.44 | $1,584.89 | $3,311.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $776.25 Median $1,479.11 Typical High $7,244.36 | Facility | None | $776.25 | $1,479.11 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,819.70 Typical High $2,511.89 | Professional | None | $1,122.02 | $1,819.70 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,949.84 Median $2,691.53 Typical High $3,801.89 | Professional | 50 · Both sides | $1,949.84 | $2,691.53 | $3,801.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $812.83 Median $1,148.15 Typical High $1,584.89 | Professional | 62 · Two surgeons | $812.83 | $1,148.15 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $288.40 Typical High $398.11 | Professional | 80 · Assistant surgeon | $208.93 | $288.40 | $398.11 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $251.19 Typical High $354.81 | Professional | AS · PA/NP assist | $181.97 | $251.19 | $354.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,318.26 Median $1,479.11 Typical High $4,168.69 | Professional | None | $1,318.26 | $1,479.11 | $4,168.69 |
Oscar Health Setting Professional Modifier None Typical Low $1,659.59 Median $1,905.46 Typical High $1,995.26 | Professional | None | $1,659.59 | $1,905.46 | $1,995.26 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $3,019.95 Typical High $8,709.64 | Facility | None | $1,288.25 | $3,019.95 | $8,709.64 |
United Setting Professional Modifier None Typical Low $1,230.27 Median $1,862.09 Typical High $3,548.13 | Professional | None | $1,230.27 | $1,862.09 | $3,548.13 |
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 $741.31 Median $776.25 Typical High $851.14 | Professional | 52 · Reduced service | $741.31 | $776.25 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $309.03 Typical High $338.84 | Professional | 53 · Discontinued | $295.12 | $309.03 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,148.15 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,122.02 | $1,148.15 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $229.09 Typical High $251.19 | Professional | 55 · Aftercare only | $223.87 | $229.09 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $154.88 Typical High $169.82 | Professional | 56 · Pre-op care only | $147.91 | $154.88 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,071.52 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,071.52 | $1,174.90 |
Where Georgia sits
The same service costs 8.3 times more in Wyoming 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· 27th of 51
$1,820
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.