How much rates vary
Facilitymedian $2,818 · 10th to 90th $631 to $7,079Professionalmedian $1,000 · 10th to 90th $646 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 $724.44 Median $5,370.32 Typical High $7,943.28 | Facility | None | $724.44 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $812.83 | Professional | None | $724.44 | $724.44 | $812.83 |
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 $1,000.00 Typical High $1,737.80 | Professional | None | $645.65 | $1,000.00 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,071.52 Median $1,584.89 Typical High $2,570.40 | Professional | 50 · Both sides | $1,071.52 | $1,584.89 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $186.21 Typical High $275.42 | Professional | 80 · Assistant surgeon | $112.20 | $186.21 | $275.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $147.91 Typical High $239.88 | Professional | AS · PA/NP assist | $100.00 | $147.91 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $4,265.80 Typical High $5,370.32 | Facility | None | $630.96 | $4,265.80 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,174.90 Typical High $1,862.09 | Professional | None | $794.33 | $1,174.90 | $1,862.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $741.31 Median $831.76 Typical High $1,621.81 | Professional | None | $741.31 | $831.76 | $1,621.81 |
Oscar Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
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 $1,122.02 Typical High $1,905.46 | Professional | None | $645.65 | $1,122.02 | $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 $354.81 Median $363.08 Typical High $407.38 | Professional | 52 · Reduced service | $354.81 | $363.08 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $144.54 Typical High $162.18 | Professional | 53 · Discontinued | $141.25 | $144.54 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $549.54 Typical High $602.56 | Professional | 54 · Surgery only | $537.03 | $549.54 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $109.65 Typical High $120.23 | Professional | 55 · Aftercare only | $107.15 | $109.65 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $72.44 Typical High $81.28 | Professional | 56 · Pre-op care only | $70.79 | $72.44 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $512.86 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $501.19 | $512.86 | $562.34 |
Where Georgia sits
The same service costs 8.7 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· 22nd of 51
$1,047
AK $2,884TX $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.