How much rates vary
Facilitymedian $661 · 10th to 90th $331 to $4,266Professionalmedian $389 · 10th to 90th $245 to $708
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 $389.05 Median $3,548.13 Typical High $7,585.78 | Facility | None | $389.05 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $389.05 Typical High $831.76 | Professional | None | $263.03 | $389.05 | $831.76 |
Ambetter Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $512.86 Median $1,000.00 Typical High $4,570.88 | Facility | None | $512.86 | $1,000.00 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $218.78 Median $363.08 Typical High $602.56 | Professional | None | $218.78 | $363.08 | $602.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $41.69 Median $61.66 Typical High $100.00 | Professional | 80 · Assistant surgeon | $41.69 | $61.66 | $100.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $38.02 Median $51.29 Typical High $87.10 | Professional | AS · PA/NP assist | $38.02 | $51.29 | $87.10 |
Cigna Setting Facility Modifier None Typical Low $257.04 Median $354.81 Typical High $630.96 | Facility | None | $257.04 | $354.81 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $478.63 Typical High $851.14 | Professional | None | $295.12 | $478.63 | $851.14 |
Kaiser Permanente Setting Professional Modifier None Typical Low $295.12 Median $446.68 Typical High $2,238.72 | Professional | None | $295.12 | $446.68 | $2,238.72 |
Oscar Health Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
United Setting Facility Modifier None Typical Low $331.13 Median $501.19 Typical High $2,454.71 | Facility | None | $331.13 | $501.19 | $2,454.71 |
United Setting Professional Modifier None Typical Low $263.03 Median $457.09 Typical High $891.25 | Professional | None | $263.03 | $457.09 | $891.25 |
7 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 $131.83 Median $162.18 Typical High $199.53 | Professional | 52 · Reduced service | $131.83 | $162.18 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $64.57 Typical High $79.43 | Professional | 53 · Discontinued | $52.48 | $64.57 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $245.47 Typical High $302.00 | Professional | 54 · Surgery only | $199.53 | $245.47 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $48.98 Typical High $60.26 | Professional | 55 · Aftercare only | $39.81 | $48.98 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $32.36 Typical High $39.81 | Professional | 56 · Pre-op care only | $26.30 | $32.36 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $229.09 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $186.21 | $229.09 | $281.84 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | 51 · Multiple procedures | $380.19 | $380.19 | $380.19 |
Where Georgia sits
The same service costs 4.5 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· 26th of 51
$398
AK $1,072TX $240
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.