How much rates vary
Facilitymedian $2,818 · 10th to 90th $1,023 to $7,762Professionalmedian $2,239 · 10th to 90th $1,413 to $3,802
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 $1,659.59 Median $7,079.46 Typical High $12,302.69 | Facility | None | $1,659.59 | $7,079.46 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,659.59 Typical High $1,995.26 | Professional | None | $1,621.81 | $1,659.59 | $1,995.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $1,698.24 Typical High $7,244.36 | Facility | None | $954.99 | $1,698.24 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,412.54 Median $2,238.72 Typical High $3,548.13 | Professional | None | $1,412.54 | $2,238.72 | $3,548.13 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,398.83 Median $3,388.44 Typical High $5,623.41 | Professional | 50 · Both sides | $2,398.83 | $3,388.44 | $5,623.41 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,000.00 Median $1,412.54 Typical High $2,344.23 | Professional | 62 · Two surgeons | $1,000.00 | $1,412.54 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $251.19 Median $380.19 Typical High $602.56 | Professional | 80 · Assistant surgeon | $251.19 | $380.19 | $602.56 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $223.87 Median $316.23 Typical High $524.81 | Professional | AS · PA/NP assist | $223.87 | $316.23 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $1,122.02 Median $5,623.41 Typical High $7,244.36 | Facility | None | $1,122.02 | $5,623.41 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $2,570.40 Typical High $4,168.69 | Professional | None | $1,862.09 | $2,570.40 | $4,168.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,659.59 Median $1,862.09 Typical High $7,585.78 | Professional | None | $1,659.59 | $1,862.09 | $7,585.78 |
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 $1,445.44 Median $2,398.83 Typical High $4,073.80 | Professional | None | $1,445.44 | $2,398.83 | $4,073.80 |
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 $812.83 Median $831.76 Typical High $933.25 | Professional | 52 · Reduced service | $812.83 | $831.76 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $331.13 Typical High $371.54 | Professional | 53 · Discontinued | $323.59 | $331.13 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,258.93 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,230.27 | $1,258.93 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $251.19 Typical High $275.42 | Professional | 55 · Aftercare only | $245.47 | $251.19 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $165.96 Typical High $186.21 | Professional | 56 · Pre-op care only | $162.18 | $165.96 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,174.90 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,174.90 | $1,288.25 |
Where Georgia sits
The same service costs 20.0 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
$2,239
AK $6,457TX $324
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.