How much rates vary
Facilitymedian $1,585 · 10th to 90th $617 to $5,754Professionalmedian $1,047 · 10th to 90th $676 to $1,778
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 $758.58 Median $758.58 Typical High $1,380.38 | Professional | None | $758.58 | $758.58 | $1,380.38 |
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 $660.69 Median $1,047.13 Typical High $1,698.24 | Professional | None | $660.69 | $1,047.13 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,122.02 Median $1,584.89 Typical High $2,570.40 | Professional | 50 · Both sides | $1,122.02 | $1,584.89 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $177.83 Typical High $281.84 | Professional | 80 · Assistant surgeon | $117.49 | $177.83 | $281.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $147.91 Typical High $239.88 | Professional | AS · PA/NP assist | $104.71 | $147.91 | $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 $851.14 Median $1,174.90 Typical High $1,949.84 | Professional | None | $851.14 | $1,174.90 | $1,949.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $776.25 Median $870.96 Typical High $1,778.28 | Professional | None | $776.25 | $870.96 | $1,778.28 |
Oscar Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,288.25 Typical High $1,318.26 | Professional | None | $1,148.15 | $1,288.25 | $1,318.26 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,479.11 Typical High $5,011.87 | Facility | None | $851.14 | $1,479.11 | $5,011.87 |
United Setting Professional Modifier None Typical Low $660.69 Median $1,096.48 Typical High $1,905.46 | Professional | None | $660.69 | $1,096.48 | $1,905.46 |
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 $380.19 Median $380.19 Typical High $426.58 | Professional | 52 · Reduced service | $380.19 | $380.19 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $169.82 | Professional | 53 · Discontinued | $151.36 | $151.36 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $575.44 Typical High $630.96 | Professional | 54 · Surgery only | $562.34 | $575.44 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $114.82 Typical High $125.89 | Professional | 55 · Aftercare only | $112.20 | $114.82 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $85.11 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $537.03 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $524.81 | $537.03 | $588.84 |
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
$1,072
AK $3,020TX $398
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.