How much rates vary
Facilitymedian $912 · 10th to 90th $501 to $6,166Professionalmedian $1,995 · 10th to 90th $1,413 to $3,467
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 $1,621.81 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,621.81 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,621.81 Typical High $3,019.95 | Professional | None | $1,584.89 | $1,621.81 | $3,019.95 |
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 $1,380.38 Median $1,995.26 Typical High $3,235.94 | Professional | None | $1,380.38 | $1,995.26 | $3,235.94 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,238.72 Median $3,311.31 Typical High $4,897.79 | Professional | 50 · Both sides | $2,238.72 | $3,311.31 | $4,897.79 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $933.25 Median $1,380.38 Typical High $2,041.74 | Professional | 62 · Two surgeons | $933.25 | $1,380.38 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $239.88 Median $380.19 Typical High $537.03 | Professional | 80 · Assistant surgeon | $239.88 | $380.19 | $537.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $208.93 Median $302.00 Typical High $467.74 | Professional | AS · PA/NP assist | $208.93 | $302.00 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $549.54 Typical High $2,511.89 | Facility | None | $446.68 | $549.54 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $2,818.38 Typical High $4,677.35 | Professional | None | $1,621.81 | $2,818.38 | $4,677.35 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,548.82 Median $1,698.24 Typical High $3,890.45 | Professional | None | $1,548.82 | $1,698.24 | $3,890.45 |
United Setting Facility Modifier None Typical Low $371.54 Median $645.65 Typical High $3,981.07 | Facility | None | $371.54 | $645.65 | $3,981.07 |
United Setting Professional Modifier None Typical Low $1,513.56 Median $2,238.72 Typical High $4,897.79 | Professional | None | $1,513.56 | $2,238.72 | $4,897.79 |
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 $812.83 Typical High $977.24 | Professional | 52 · Reduced service | $794.33 | $812.83 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $323.59 Typical High $389.05 | Professional | 53 · Discontinued | $316.23 | $323.59 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,230.27 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,174.90 | $1,230.27 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $245.47 Typical High $295.12 | Professional | 55 · Aftercare only | $234.42 | $245.47 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $162.18 Typical High $194.98 | Professional | 56 · Pre-op care only | $158.49 | $162.18 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,148.15 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,148.15 | $1,380.38 |
Where Georgia sits
The same service costs 5.6 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· 27th of 51
$1,995
AK $5,754TX $1,023
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.