How much rates vary
Facilitymedian $1,175 · 10th to 90th $603 to $4,677Professionalmedian $3,388 · 10th to 90th $2,291 to $5,623
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 $2,290.87 Median $5,623.41 Typical High $10,000.00 | Facility | None | $2,290.87 | $5,623.41 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $2,290.87 Median $2,570.40 Typical High $4,073.80 | Professional | None | $2,290.87 | $2,570.40 | $4,073.80 |
Ambetter Setting Professional Modifier None Typical Low $4,570.88 Median $4,570.88 Typical High $4,570.88 | Professional | None | $4,570.88 | $4,570.88 | $4,570.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $660.69 Median $1,202.26 Typical High $4,570.88 | Facility | None | $660.69 | $1,202.26 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,344.23 Median $3,388.44 Typical High $5,495.41 | Professional | None | $2,344.23 | $3,388.44 | $5,495.41 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,548.82 Median $2,137.96 Typical High $3,548.13 | Professional | 62 · Two surgeons | $1,548.82 | $2,137.96 | $3,548.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $389.05 Median $537.03 Typical High $912.01 | Professional | 80 · Assistant surgeon | $389.05 | $537.03 | $912.01 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $338.84 Median $478.63 Typical High $794.33 | Professional | AS · PA/NP assist | $338.84 | $478.63 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,318.26 Typical High $1,819.70 | Facility | None | $741.31 | $1,318.26 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $2,290.87 Median $4,677.35 Typical High $5,248.07 | Professional | None | $2,290.87 | $4,677.35 | $5,248.07 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,691.53 Median $3,019.95 Typical High $5,011.87 | Professional | None | $2,691.53 | $3,019.95 | $5,011.87 |
United Setting Facility Modifier None Typical Low $501.19 Median $724.44 Typical High $3,548.13 | Facility | None | $501.19 | $724.44 | $3,548.13 |
United Setting Professional Modifier None Typical Low $2,570.40 Median $4,073.80 Typical High $6,918.31 | Professional | None | $2,570.40 | $4,073.80 | $6,918.31 |
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 $1,148.15 Median $1,202.26 Typical High $1,445.44 | Professional | 52 · Reduced service | $1,148.15 | $1,202.26 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $478.63 Typical High $588.84 | Professional | 53 · Discontinued | $467.74 | $478.63 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $1,778.28 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,737.80 | $1,778.28 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $363.08 Typical High $436.52 | Professional | 55 · Aftercare only | $346.74 | $363.08 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $239.88 Typical High $295.12 | Professional | 56 · Pre-op care only | $229.09 | $239.88 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,659.59 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,659.59 | $2,041.74 |
Where Georgia sits
The same service costs 15.8 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· 21st of 51
$3,090
AK $8,128TX $513
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.