How much rates vary
Facilitymedian $2,951 · 10th to 90th $724 to $7,762Professionalmedian $1,479 · 10th to 90th $977 to $2,399
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 $1,096.48 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,096.48 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,096.48 Typical High $1,698.24 | Professional | None | $1,071.52 | $1,096.48 | $1,698.24 |
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 $912.01 Median $1,479.11 Typical High $2,290.87 | Professional | None | $912.01 | $1,479.11 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,584.89 Median $2,454.71 Typical High $3,467.37 | Professional | 50 · Both sides | $1,584.89 | $2,454.71 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $660.69 Median $1,023.29 Typical High $1,445.44 | Professional | 62 · Two surgeons | $660.69 | $1,023.29 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $275.42 Typical High $380.19 | Professional | 80 · Assistant surgeon | $165.96 | $275.42 | $380.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $229.09 Typical High $323.59 | Professional | AS · PA/NP assist | $147.91 | $229.09 | $323.59 |
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 $1,148.15 Median $1,621.81 Typical High $3,311.31 | Professional | None | $1,148.15 | $1,621.81 | $3,311.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,023.29 Median $1,202.26 Typical High $2,187.76 | Professional | None | $1,023.29 | $1,202.26 | $2,187.76 |
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 $1,023.29 Median $1,698.24 Typical High $3,388.44 | Professional | None | $1,023.29 | $1,698.24 | $3,388.44 |
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 $537.03 Median $549.54 Typical High $676.08 | Professional | 52 · Reduced service | $537.03 | $549.54 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $218.78 Typical High $269.15 | Professional | 53 · Discontinued | $213.80 | $218.78 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $831.76 Typical High $1,000.00 | Professional | 54 · Surgery only | $812.83 | $831.76 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $165.96 Typical High $199.53 | Professional | 55 · Aftercare only | $162.18 | $165.96 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $109.65 Typical High $134.90 | Professional | 56 · Pre-op care only | $107.15 | $109.65 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $776.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $758.58 | $776.25 | $933.25 |
Where Georgia sits
The same service costs 5.0 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· 22nd of 51
$1,660
WI $4,365TX $871
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.