How much rates vary
Facilitymedian $2,188 · 10th to 90th $631 to $7,943Professionalmedian $1,202 · 10th to 90th $794 to $2,089
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 $870.96 Median $891.25 Typical High $2,290.87 | Professional | None | $870.96 | $891.25 | $2,290.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,548.82 Typical High $10,964.78 | Facility | None | $588.84 | $1,548.82 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $776.25 Median $1,202.26 Typical High $1,949.84 | Professional | None | $776.25 | $1,202.26 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $549.54 Median $758.58 Typical High $1,230.27 | Professional | 62 · Two surgeons | $549.54 | $758.58 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $138.04 Median $208.93 Typical High $323.59 | Professional | 80 · Assistant surgeon | $138.04 | $208.93 | $323.59 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $169.82 Typical High $281.84 | Professional | AS · PA/NP assist | $120.23 | $169.82 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $5,623.41 Typical High $7,079.46 | Facility | None | $602.56 | $5,623.41 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,258.93 Typical High $2,290.87 | Professional | None | $912.01 | $1,258.93 | $2,290.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $954.99 Median $1,047.13 Typical High $1,621.81 | Professional | None | $954.99 | $1,047.13 | $1,621.81 |
Oscar Health Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,513.56 | $1,513.56 | $1,513.56 |
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 $758.58 Median $1,258.93 Typical High $2,238.72 | Professional | None | $758.58 | $1,258.93 | $2,238.72 |
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 $436.52 Median $446.68 Typical High $489.78 | Professional | 52 · Reduced service | $436.52 | $446.68 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $177.83 Typical High $194.98 | Professional | 53 · Discontinued | $173.78 | $177.83 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $676.08 Typical High $741.31 | Professional | 54 · Surgery only | $645.65 | $676.08 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $134.90 Typical High $147.91 | Professional | 55 · Aftercare only | $128.82 | $134.90 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $89.13 Typical High $97.72 | Professional | 56 · Pre-op care only | $87.10 | $89.13 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $630.96 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $602.56 | $630.96 | $691.83 |
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
$1,230
AK $3,548TX $468
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.