How much rates vary
Facilitymedian $4,677 · 10th to 90th $1,072 to $16,982Professionalmedian $4,571 · 10th to 90th $3,090 to $7,586
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 $3,311.31 Median $5,370.32 Typical High $7,943.28 | Facility | None | $3,311.31 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,801.89 | Professional | None | $3,311.31 | $3,311.31 | $3,801.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,071.52 Median $1,905.46 Typical High $11,220.18 | Facility | None | $1,071.52 | $1,905.46 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,090.30 Median $4,570.88 Typical High $7,413.10 | Professional | None | $3,090.30 | $4,570.88 | $7,413.10 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $4,897.79 Median $7,079.46 Typical High $11,481.54 | Professional | 50 · Both sides | $4,897.79 | $7,079.46 | $11,481.54 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,041.74 Median $3,019.95 Typical High $4,897.79 | Professional | 62 · Two surgeons | $2,041.74 | $3,019.95 | $4,897.79 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $512.86 Median $812.83 Typical High $1,230.27 | Professional | 80 · Assistant surgeon | $512.86 | $812.83 | $1,230.27 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $457.09 Median $660.69 Typical High $1,071.52 | Professional | AS · PA/NP assist | $457.09 | $660.69 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $15,488.17 Typical High $19,498.45 | Facility | None | $630.96 | $15,488.17 | $19,498.45 |
Cigna Setting Professional Modifier None Typical Low $3,801.89 Median $5,248.07 Typical High $8,511.38 | Professional | None | $3,801.89 | $5,248.07 | $8,511.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,311.31 Median $3,715.35 Typical High $8,128.31 | Professional | None | $3,311.31 | $3,715.35 | $8,128.31 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $6,760.83 Typical High $12,882.50 | Facility | None | $1,513.56 | $6,760.83 | $12,882.50 |
United Setting Professional Modifier None Typical Low $2,951.21 Median $4,897.79 Typical High $8,317.64 | Professional | None | $2,951.21 | $4,897.79 | $8,317.64 |
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 $1,659.59 Median $1,659.59 Typical High $1,905.46 | Professional | 52 · Reduced service | $1,659.59 | $1,659.59 | $1,905.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $676.08 Median $676.08 Typical High $758.58 | Professional | 53 · Discontinued | $676.08 | $676.08 | $758.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,511.89 Median $2,511.89 Typical High $2,818.38 | Professional | 54 · Surgery only | $2,511.89 | $2,511.89 | $2,818.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $501.19 Median $501.19 Typical High $562.34 | Professional | 55 · Aftercare only | $501.19 | $501.19 | $562.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $331.13 Median $331.13 Typical High $380.19 | Professional | 56 · Pre-op care only | $331.13 | $331.13 | $380.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,344.23 Median $2,344.23 Typical High $2,630.27 | Professional | 78 · Unplanned return to OR | $2,344.23 | $2,344.23 | $2,630.27 |
Where Georgia sits
The same service costs 20.4 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· 22nd of 51
$4,571
AK $13,183TX $646
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.