How much rates vary
Facilitymedian $2,692 · 10th to 90th $631 to $7,079Professionalmedian $1,023 · 10th to 90th $661 to $1,738
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 $977.24 Median $5,370.32 Typical High $7,943.28 | Facility | None | $977.24 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,023.29 | Professional | None | $741.31 | $741.31 | $1,023.29 |
Ambetter Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | None | $954.99 | $954.99 | $954.99 |
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 $645.65 Median $1,023.29 Typical High $1,659.59 | Professional | None | $645.65 | $1,023.29 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,096.48 Median $1,548.82 Typical High $2,511.89 | Professional | 50 · Both sides | $1,096.48 | $1,548.82 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $173.78 Typical High $275.42 | Professional | 80 · Assistant surgeon | $114.82 | $173.78 | $275.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $144.54 Typical High $239.88 | Professional | AS · PA/NP assist | $102.33 | $144.54 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,073.80 Typical High $5,128.61 | Facility | None | $602.56 | $4,073.80 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,148.15 Typical High $1,905.46 | Professional | None | $831.76 | $1,148.15 | $1,905.46 |
Kaiser Permanente Setting Professional Modifier None Typical Low $758.58 Median $851.14 Typical High $1,819.70 | Professional | None | $758.58 | $851.14 | $1,819.70 |
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 $645.65 Median $1,071.52 Typical High $1,819.70 | Professional | None | $645.65 | $1,071.52 | $1,819.70 |
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 $371.54 Median $371.54 Typical High $416.87 | Professional | 52 · Reduced service | $371.54 | $371.54 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $165.96 | Professional | 53 · Discontinued | $147.91 | $147.91 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $616.60 | Professional | 54 · Surgery only | $549.54 | $549.54 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $112.20 Typical High $123.03 | Professional | 55 · Aftercare only | $109.65 | $112.20 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $83.18 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $512.86 | $512.86 | $575.44 |
Where Georgia sits
The same service costs 7.8 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· 23rd of 51
$1,047
AK $2,951TX $380
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.