How much rates vary
Facilitymedian $3,020 · 10th to 90th $631 to $7,079Professionalmedian $2,512 · 10th to 90th $1,549 to $4,266
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 $1,778.28 Median $6,309.57 Typical High $10,000.00 | Facility | None | $1,778.28 | $6,309.57 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,089.30 | Professional | None | $1,778.28 | $1,778.28 | $2,089.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $1,148.15 Typical High $5,754.40 | Facility | None | $575.44 | $1,148.15 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,513.56 Median $2,511.89 Typical High $4,073.80 | Professional | None | $1,513.56 | $2,511.89 | $4,073.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,122.02 Median $1,584.89 Typical High $2,570.40 | Professional | 62 · Two surgeons | $1,122.02 | $1,584.89 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $269.15 Median $407.38 Typical High $676.08 | Professional | 80 · Assistant surgeon | $269.15 | $407.38 | $676.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $245.47 Median $354.81 Typical High $575.44 | Professional | AS · PA/NP assist | $245.47 | $354.81 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,168.69 Typical High $5,370.32 | Facility | None | $602.56 | $4,168.69 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $2,754.23 Typical High $4,786.30 | Professional | None | $1,862.09 | $2,754.23 | $4,786.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,041.74 Median $2,290.87 Typical High $4,677.35 | Professional | None | $2,041.74 | $2,290.87 | $4,677.35 |
Oscar Health Setting Professional Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,235.94 | Professional | None | $3,235.94 | $3,235.94 | $3,235.94 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $3,715.35 Typical High $9,549.93 | Facility | None | $1,513.56 | $3,715.35 | $9,549.93 |
United Setting Professional Modifier None Typical Low $1,445.44 Median $2,344.23 Typical High $4,786.30 | Professional | None | $1,445.44 | $2,344.23 | $4,786.30 |
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 $891.25 Median $891.25 Typical High $1,000.00 | Professional | 52 · Reduced service | $891.25 | $891.25 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $354.81 Typical High $398.11 | Professional | 53 · Discontinued | $354.81 | $354.81 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,348.96 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,318.26 | $1,348.96 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $269.15 Typical High $302.00 | Professional | 55 · Aftercare only | $263.03 | $269.15 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $177.83 Typical High $199.53 | Professional | 56 · Pre-op care only | $177.83 | $177.83 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,258.93 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,258.93 | $1,412.54 |
Where Georgia sits
The same service costs 11.2 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· 19th of 51
$2,512
AK $7,244TX $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.