How much rates vary
Facilitymedian $1,995 · 10th to 90th $617 to $6,310Professionalmedian $794 · 10th to 90th $525 to $1,380
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 $575.44 Median $575.44 Typical High $1,513.56 | Professional | None | $575.44 | $575.44 | $1,513.56 |
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 $501.19 Median $794.33 Typical High $1,288.25 | Professional | None | $501.19 | $794.33 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $851.14 Median $1,230.27 Typical High $1,995.26 | Professional | 50 · Both sides | $851.14 | $1,230.27 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $354.81 Median $524.81 Typical High $831.76 | Professional | 62 · Two surgeons | $354.81 | $524.81 | $831.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $91.20 Median $138.04 Typical High $218.78 | Professional | 80 · Assistant surgeon | $91.20 | $138.04 | $218.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $79.43 Median $114.82 Typical High $190.55 | Professional | AS · PA/NP assist | $79.43 | $114.82 | $190.55 |
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 $630.96 Median $891.25 Typical High $1,513.56 | Professional | None | $630.96 | $891.25 | $1,513.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $616.60 Median $676.08 Typical High $1,348.96 | Professional | None | $616.60 | $676.08 | $1,348.96 |
Oscar Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | None | $1,023.29 | $1,023.29 | $1,023.29 |
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 $512.86 Median $851.14 Typical High $1,445.44 | Professional | None | $512.86 | $851.14 | $1,445.44 |
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 $281.84 Median $288.40 Typical High $323.59 | Professional | 52 · Reduced service | $281.84 | $288.40 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $114.82 Typical High $128.82 | Professional | 53 · Discontinued | $114.82 | $114.82 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $436.52 Typical High $478.63 | Professional | 54 · Surgery only | $426.58 | $436.52 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $87.10 Typical High $95.50 | Professional | 55 · Aftercare only | $85.11 | $87.10 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $64.57 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $407.38 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $398.11 | $407.38 | $446.68 |
Where Georgia sits
The same service costs 7.6 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
$851
AK $2,344TX $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.