How much rates vary
Facilitymedian $2,692 · 10th to 90th $759 to $7,244Professionalmedian $1,122 · 10th to 90th $741 to $1,820
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 $1,202.26 Median $5,370.32 Typical High $8,317.64 | Facility | None | $1,202.26 | $5,370.32 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,862.09 | Professional | None | $912.01 | $912.01 | $1,862.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $691.83 Median $1,380.38 Typical High $7,244.36 | Facility | None | $691.83 | $1,380.38 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $707.95 Median $1,148.15 Typical High $1,698.24 | Professional | None | $707.95 | $1,148.15 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,230.27 Median $1,737.80 Typical High $2,570.40 | Professional | 50 · Both sides | $1,230.27 | $1,737.80 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $512.86 Median $724.44 Typical High $1,071.52 | Professional | 62 · Two surgeons | $512.86 | $724.44 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $128.82 Median $186.21 Typical High $288.40 | Professional | 80 · Assistant surgeon | $128.82 | $186.21 | $288.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $162.18 Typical High $239.88 | Professional | AS · PA/NP assist | $114.82 | $162.18 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $3,388.44 Typical High $4,365.16 | Facility | None | $741.31 | $3,388.44 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,202.26 Typical High $2,187.76 | Professional | None | $831.76 | $1,202.26 | $2,187.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $758.58 Median $933.25 Typical High $2,398.83 | Professional | None | $758.58 | $933.25 | $2,398.83 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $2,884.03 Typical High $8,709.64 | Facility | None | $1,258.93 | $2,884.03 | $8,709.64 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,174.90 Typical High $2,344.23 | Professional | None | $776.25 | $1,174.90 | $2,344.23 |
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 $457.09 Median $457.09 Typical High $501.19 | Professional | 52 · Reduced service | $457.09 | $457.09 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $199.53 | Professional | 53 · Discontinued | $181.97 | $181.97 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $676.08 Typical High $758.58 | Professional | 54 · Surgery only | $676.08 | $676.08 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $151.36 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $100.00 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $630.96 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $630.96 | $630.96 | $707.95 |
Where Georgia sits
The same service costs 7.4 times more in Oklahoma 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· 27th of 51
$1,148
OK $3,890TX $525
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.