How much rates vary
Facilitymedian $1,995 · 10th to 90th $631 to $6,607Professionalmedian $2,138 · 10th to 90th $1,380 to $3,631
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 $1,584.89 Median $5,623.41 Typical High $10,000.00 | Facility | None | $1,584.89 | $5,623.41 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,862.09 | Professional | None | $1,584.89 | $1,584.89 | $1,862.09 |
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 $1,380.38 Median $2,137.96 Typical High $3,467.37 | Professional | None | $1,380.38 | $2,137.96 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,344.23 Median $3,388.44 Typical High $5,495.41 | Professional | 50 · Both sides | $2,344.23 | $3,388.44 | $5,495.41 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $245.47 Median $380.19 Typical High $588.84 | Professional | 80 · Assistant surgeon | $245.47 | $380.19 | $588.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $218.78 Median $316.23 Typical High $512.86 | Professional | AS · PA/NP assist | $218.78 | $316.23 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,511.89 Typical High $3,162.28 | Facility | None | $630.96 | $2,511.89 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $1,778.28 Median $2,570.40 Typical High $4,073.80 | Professional | None | $1,778.28 | $2,570.40 | $4,073.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,584.89 Median $1,778.28 Typical High $3,388.44 | Professional | None | $1,584.89 | $1,778.28 | $3,388.44 |
Oscar Health Setting Professional Modifier None Typical Low $2,398.83 Median $2,691.53 Typical High $2,754.23 | Professional | None | $2,398.83 | $2,691.53 | $2,754.23 |
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 $1,412.54 Median $2,290.87 Typical High $3,981.07 | Professional | None | $1,412.54 | $2,290.87 | $3,981.07 |
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 $794.33 Median $794.33 Typical High $891.25 | Professional | 52 · Reduced service | $794.33 | $794.33 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $316.23 Typical High $354.81 | Professional | 53 · Discontinued | $316.23 | $316.23 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,202.26 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,202.26 | $1,202.26 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $239.88 Typical High $269.15 | Professional | 55 · Aftercare only | $239.88 | $239.88 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $158.49 Typical High $177.83 | Professional | 56 · Pre-op care only | $158.49 | $158.49 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,122.02 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,122.02 | $1,258.93 |
Where Georgia sits
The same service costs 16.2 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
$2,138
AK $6,310TX $389
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.