How much rates vary
Facilitymedian $2,692 · 10th to 90th $724 to $7,413Professionalmedian $1,738 · 10th to 90th $1,096 to $2,884
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 $1,258.93 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,258.93 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,412.54 | Professional | None | $1,258.93 | $1,258.93 | $1,412.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $691.83 Median $1,348.96 Typical High $7,244.36 | Facility | None | $691.83 | $1,348.96 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,737.80 Typical High $2,818.38 | Professional | None | $1,071.52 | $1,737.80 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,862.09 Median $2,630.27 Typical High $4,265.80 | Professional | 50 · Both sides | $1,862.09 | $2,630.27 | $4,265.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $776.25 Median $1,122.02 Typical High $1,778.28 | Professional | 62 · Two surgeons | $776.25 | $1,122.02 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $288.40 Typical High $467.74 | Professional | 80 · Assistant surgeon | $194.98 | $288.40 | $467.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $239.88 Typical High $398.11 | Professional | AS · PA/NP assist | $173.78 | $239.88 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,365.16 Typical High $5,623.41 | Facility | None | $602.56 | $4,365.16 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $1,949.84 Typical High $3,235.94 | Professional | None | $1,412.54 | $1,949.84 | $3,235.94 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,258.93 Median $1,412.54 Typical High $5,370.32 | Professional | None | $1,258.93 | $1,412.54 | $5,370.32 |
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 $1,096.48 Median $1,819.70 Typical High $3,162.28 | Professional | None | $1,096.48 | $1,819.70 | $3,162.28 |
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 $630.96 Median $630.96 Typical High $707.95 | Professional | 52 · Reduced service | $630.96 | $630.96 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $257.04 Typical High $281.84 | Professional | 53 · Discontinued | $251.19 | $257.04 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $954.99 Typical High $1,071.52 | Professional | 54 · Surgery only | $933.25 | $954.99 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $190.55 Typical High $213.80 | Professional | 55 · Aftercare only | $186.21 | $190.55 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $141.25 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $891.25 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $870.96 | $891.25 | $1,000.00 |
Where Georgia sits
The same service costs 16.2 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· 24th of 51
$1,738
AK $5,012TX $309
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.