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 $5,623.41 Typical High $9,549.93 | Facility | None | $1,202.26 | $5,623.41 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,202.26 Typical High $1,862.09 | Professional | None | $1,122.02 | $1,202.26 | $1,862.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $1,288.25 Typical High $4,570.88 | Facility | None | $724.44 | $1,288.25 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $812.83 Median $1,348.96 Typical High $1,862.09 | Professional | None | $812.83 | $1,348.96 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,445.44 Median $1,995.26 Typical High $2,818.38 | Professional | 50 · Both sides | $1,445.44 | $1,995.26 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $208.93 Typical High $302.00 | Professional | 80 · Assistant surgeon | $151.36 | $208.93 | $302.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $190.55 Typical High $263.03 | Professional | AS · PA/NP assist | $131.83 | $190.55 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $1,445.44 Typical High $1,995.26 | Facility | None | $812.83 | $1,445.44 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,445.44 Typical High $2,570.40 | Professional | None | $977.24 | $1,445.44 | $2,570.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,000.00 Median $1,122.02 Typical High $1,819.70 | Professional | None | $1,000.00 | $1,122.02 | $1,819.70 |
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 $891.25 Median $1,348.96 Typical High $2,630.27 | Professional | None | $891.25 | $1,348.96 | $2,630.27 |
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 $562.34 Median $575.44 Typical High $630.96 | Professional | 52 · Reduced service | $562.34 | $575.44 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $229.09 Typical High $251.19 | Professional | 53 · Discontinued | $223.87 | $229.09 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $851.14 Typical High $954.99 | Professional | 54 · Surgery only | $831.76 | $851.14 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $173.78 Typical High $190.55 | Professional | 55 · Aftercare only | $165.96 | $173.78 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $114.82 Typical High $125.89 | Professional | 56 · Pre-op care only | $112.20 | $114.82 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $794.33 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $776.25 | $794.33 | $891.25 |
Where Georgia sits
The same service costs 7.2 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· 21st of 51
$1,349
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.