How much rates vary
Facilitymedian $3,311 · 10th to 90th $776 to $12,882Professionalmedian $1,778 · 10th to 90th $1,148 to $3,020
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 $1,288.25 Median $5,623.41 Typical High $18,197.01 | Facility | None | $1,288.25 | $5,623.41 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,584.89 | Professional | None | $1,288.25 | $1,288.25 | $1,584.89 |
Ambetter Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,202.26 | $1,202.26 | $1,202.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $707.95 Median $1,659.59 Typical High $13,803.84 | Facility | None | $707.95 | $1,659.59 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $1,778.28 Typical High $2,884.03 | Professional | None | $1,096.48 | $1,778.28 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,905.46 Median $2,691.53 Typical High $4,365.16 | Professional | 50 · Both sides | $1,905.46 | $2,691.53 | $4,365.16 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $794.33 Median $1,122.02 Typical High $1,819.70 | Professional | 62 · Two surgeons | $794.33 | $1,122.02 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $302.00 Typical High $478.63 | Professional | 80 · Assistant surgeon | $204.17 | $302.00 | $478.63 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $251.19 Typical High $416.87 | Professional | AS · PA/NP assist | $177.83 | $251.19 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $10,471.29 Typical High $13,489.63 | Facility | None | $741.31 | $10,471.29 | $13,489.63 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,995.26 Typical High $3,311.31 | Professional | None | $1,445.44 | $1,995.26 | $3,311.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,318.26 Median $1,479.11 Typical High $3,311.31 | Professional | None | $1,318.26 | $1,479.11 | $3,311.31 |
Oscar Health Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,290.87 | Professional | None | $2,238.72 | $2,238.72 | $2,290.87 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $3,715.35 Typical High $10,000.00 | Facility | None | $1,513.56 | $3,715.35 | $10,000.00 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,862.09 Typical High $3,235.94 | Professional | None | $1,122.02 | $1,862.09 | $3,235.94 |
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 $645.65 Median $645.65 Typical High $724.44 | Professional | 52 · Reduced service | $645.65 | $645.65 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $288.40 | Professional | 53 · Discontinued | $257.04 | $257.04 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $977.24 Typical High $1,071.52 | Professional | 54 · Surgery only | $954.99 | $977.24 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $194.98 Typical High $218.78 | Professional | 55 · Aftercare only | $190.55 | $194.98 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $144.54 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $912.01 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $891.25 | $912.01 | $1,000.00 |
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· 24th of 51
$1,778
AK $5,129TX $676
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.