How much rates vary
Facilitymedian $1,995 · 10th to 90th $617 to $7,079Professionalmedian $1,000 · 10th to 90th $661 to $1,698
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 $741.31 Median $5,370.32 Typical High $7,943.28 | Facility | None | $741.31 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $741.31 Typical High $812.83 | Professional | None | $724.44 | $741.31 | $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 $630.96 Median $1,000.00 Typical High $1,621.81 | Professional | None | $630.96 | $1,000.00 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,047.13 Median $1,513.56 Typical High $2,454.71 | Professional | 50 · Both sides | $1,047.13 | $1,513.56 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $165.96 Typical High $275.42 | Professional | 80 · Assistant surgeon | $112.20 | $165.96 | $275.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $97.72 Median $141.25 Typical High $229.09 | Professional | AS · PA/NP assist | $97.72 | $141.25 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,995.26 Typical High $2,691.53 | Facility | None | $602.56 | $1,995.26 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,071.52 Typical High $1,905.46 | Professional | None | $776.25 | $1,071.52 | $1,905.46 |
Kaiser Permanente Setting Professional Modifier None Typical Low $776.25 Median $851.14 Typical High $1,513.56 | Professional | None | $776.25 | $851.14 | $1,513.56 |
Oscar Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,288.25 | $1,288.25 | $1,288.25 |
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 $630.96 Median $1,047.13 Typical High $1,819.70 | Professional | None | $630.96 | $1,047.13 | $1,819.70 |
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 $363.08 Median $371.54 Typical High $407.38 | Professional | 52 · Reduced service | $363.08 | $371.54 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $147.91 Typical High $162.18 | Professional | 53 · Discontinued | $144.54 | $147.91 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $549.54 Typical High $616.60 | Professional | 54 · Surgery only | $537.03 | $549.54 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $109.65 Typical High $123.03 | Professional | 55 · Aftercare only | $107.15 | $109.65 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $74.13 Typical High $81.28 | Professional | 56 · Pre-op care only | $72.44 | $74.13 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $512.86 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $501.19 | $512.86 | $575.44 |
Where Georgia sits
The same service costs 19.5 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
$1,000
AK $2,951TX $151
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.