How much rates vary
Facilitymedian $1,820 · 10th to 90th $617 to $6,166Professionalmedian $851 · 10th to 90th $562 to $1,514
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 $616.60 Median $616.60 Typical High $1,202.26 | Professional | None | $616.60 | $616.60 | $1,202.26 |
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 $562.34 Median $851.14 Typical High $1,513.56 | Professional | None | $562.34 | $851.14 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $933.25 Median $1,348.96 Typical High $2,290.87 | Professional | 50 · Both sides | $933.25 | $1,348.96 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $97.72 Median $162.18 Typical High $257.04 | Professional | 80 · Assistant surgeon | $97.72 | $162.18 | $257.04 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $87.10 Median $125.89 Typical High $213.80 | Professional | AS · PA/NP assist | $87.10 | $125.89 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,905.46 Typical High $2,511.89 | Facility | None | $602.56 | $1,905.46 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $1,000.00 Typical High $1,584.89 | Professional | None | $676.08 | $1,000.00 | $1,584.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $645.65 Median $724.44 Typical High $1,548.82 | Professional | None | $645.65 | $724.44 | $1,548.82 |
Oscar Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,096.48 | $1,096.48 | $1,096.48 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $7,585.78 | Facility | None | $954.99 | $1,995.26 | $7,585.78 |
United Setting Professional Modifier None Typical Low $562.34 Median $1,000.00 Typical High $1,621.81 | Professional | None | $562.34 | $1,000.00 | $1,621.81 |
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 $309.03 Median $309.03 Typical High $346.74 | Professional | 52 · Reduced service | $309.03 | $309.03 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $138.04 | Professional | 53 · Discontinued | $123.03 | $123.03 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $467.74 Typical High $512.86 | Professional | 54 · Surgery only | $457.09 | $467.74 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $93.33 Typical High $102.33 | Professional | 55 · Aftercare only | $91.20 | $93.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $69.18 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $436.52 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $426.58 | $436.52 | $478.63 |
Where Georgia sits
The same service costs 7.4 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
$933
AK $2,455TX $331
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.