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 $1,096.48 Median $1,148.15 Typical High $2,754.23 | Professional | None | $1,096.48 | $1,148.15 | $2,754.23 |
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 $1,000.00 Median $1,621.81 Typical High $2,570.40 | Professional | None | $1,000.00 | $1,621.81 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,737.80 Median $2,398.83 Typical High $3,981.07 | Professional | 50 · Both sides | $1,737.80 | $2,398.83 | $3,981.07 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $269.15 Typical High $446.68 | Professional | 80 · Assistant surgeon | $186.21 | $269.15 | $446.68 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $223.87 Typical High $389.05 | Professional | AS · PA/NP assist | $162.18 | $223.87 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $3,467.37 Typical High $4,365.16 | Facility | None | $812.83 | $3,467.37 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,862.09 Typical High $3,019.95 | Professional | None | $1,258.93 | $1,862.09 | $3,019.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,047.13 Median $1,288.25 Typical High $3,548.13 | Professional | None | $1,047.13 | $1,288.25 | $3,548.13 |
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 $1,148.15 Median $1,698.24 Typical High $2,884.03 | Professional | None | $1,148.15 | $1,698.24 | $2,884.03 |
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 $549.54 Median $549.54 Typical High $645.65 | Professional | 52 · Reduced service | $549.54 | $549.54 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $257.04 | Professional | 53 · Discontinued | $218.78 | $218.78 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $954.99 | Professional | 54 · Surgery only | $812.83 | $812.83 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $190.55 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $128.82 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $891.25 |
Where Georgia sits
The same service costs 6.8 times more in Alaska than in Texas. 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· 25th of 51
$1,622
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.