How much rates vary
Facilitymedian $2,951 · 10th to 90th $724 to $7,762Professionalmedian $1,549 · 10th to 90th $1,000 to $2,570
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 $1,148.15 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,148.15 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,148.15 Typical High $1,621.81 | Professional | None | $1,122.02 | $1,148.15 | $1,621.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $691.83 Median $1,348.96 Typical High $7,244.36 | Facility | None | $691.83 | $1,348.96 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $954.99 Median $1,584.89 Typical High $2,454.71 | Professional | None | $954.99 | $1,584.89 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,621.81 Median $2,570.40 Typical High $3,801.89 | Professional | 50 · Both sides | $1,621.81 | $2,570.40 | $3,801.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $691.83 Median $1,071.52 Typical High $1,584.89 | Professional | 62 · Two surgeons | $691.83 | $1,071.52 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $257.04 Typical High $426.58 | Professional | 80 · Assistant surgeon | $169.82 | $257.04 | $426.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $239.88 Typical High $346.74 | Professional | AS · PA/NP assist | $151.36 | $239.88 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,630.78 Typical High $4,570.88 | Facility | None | $602.56 | $3,630.78 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,778.28 Typical High $3,388.44 | Professional | None | $1,174.90 | $1,778.28 | $3,388.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,071.52 Median $1,174.90 Typical High $2,089.30 | Professional | None | $1,071.52 | $1,174.90 | $2,089.30 |
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 $1,071.52 Median $1,737.80 Typical High $3,467.37 | Professional | None | $1,071.52 | $1,737.80 | $3,467.37 |
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 $562.34 Median $575.44 Typical High $691.83 | Professional | 52 · Reduced service | $562.34 | $575.44 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $229.09 Typical High $275.42 | Professional | 53 · Discontinued | $223.87 | $229.09 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $851.14 Typical High $1,047.13 | Professional | 54 · Surgery only | $831.76 | $851.14 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $169.82 Typical High $208.93 | Professional | 55 · Aftercare only | $165.96 | $169.82 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $114.82 Typical High $138.04 | Professional | 56 · Pre-op care only | $112.20 | $114.82 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $794.33 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $776.25 | $794.33 | $977.24 |
Where Georgia sits
The same service costs 5.1 times more in Wisconsin 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· 29th of 51
$1,698
WI $4,677TX $912
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.