How much rates vary
Facilitymedian $1,995 · 10th to 90th $631 to $6,310Professionalmedian $1,096 · 10th to 90th $724 to $1,950
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 $776.25 Median $794.33 Typical High $1,071.52 | Professional | None | $776.25 | $794.33 | $1,071.52 |
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 $724.44 Median $1,096.48 Typical High $1,905.46 | Professional | None | $724.44 | $1,096.48 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,174.90 Median $1,737.80 Typical High $2,884.03 | Professional | 50 · Both sides | $1,174.90 | $1,737.80 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $208.93 Typical High $309.03 | Professional | 80 · Assistant surgeon | $123.03 | $208.93 | $309.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $109.65 Median $162.18 Typical High $269.15 | Professional | AS · PA/NP assist | $109.65 | $162.18 | $269.15 |
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 $870.96 Median $1,258.93 Typical High $2,041.74 | Professional | None | $870.96 | $1,258.93 | $2,041.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $812.83 Median $912.01 Typical High $1,949.84 | Professional | None | $812.83 | $912.01 | $1,949.84 |
Oscar Health Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,380.38 | $1,380.38 | $1,380.38 |
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 $741.31 Median $1,258.93 Typical High $2,089.30 | Professional | None | $741.31 | $1,258.93 | $2,089.30 |
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 $389.05 Median $398.11 Typical High $436.52 | Professional | 52 · Reduced service | $389.05 | $398.11 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $158.49 Typical High $177.83 | Professional | 53 · Discontinued | $154.88 | $158.49 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $660.69 | Professional | 54 · Surgery only | $588.84 | $588.84 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $131.83 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $79.43 Typical High $87.10 | Professional | 56 · Pre-op care only | $77.62 | $79.43 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $549.54 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $549.54 | $549.54 | $616.60 |
Where Georgia sits
The same service costs 8.3 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
$1,148
AK $3,162TX $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.