How much rates vary
Facilitymedian $1,820 · 10th to 90th $617 to $6,166Professionalmedian $1,479 · 10th to 90th $955 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 $1,071.52 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,071.52 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,071.52 Typical High $2,290.87 | Professional | None | $1,047.13 | $1,071.52 | $2,290.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $1,148.15 Typical High $5,754.40 | Facility | None | $575.44 | $1,148.15 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $891.25 Median $1,513.56 Typical High $2,290.87 | Professional | None | $891.25 | $1,513.56 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $1,000.00 Typical High $1,445.44 | Professional | 62 · Two surgeons | $645.65 | $1,000.00 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $269.15 Typical High $380.19 | Professional | 80 · Assistant surgeon | $162.18 | $269.15 | $380.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $223.87 Typical High $323.59 | Professional | AS · PA/NP assist | $144.54 | $223.87 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,949.84 Typical High $2,691.53 | Facility | None | $602.56 | $1,949.84 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $2,137.96 Typical High $3,235.94 | Professional | None | $1,122.02 | $2,137.96 | $3,235.94 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $2,951.21 | Professional | None | $1,000.00 | $1,174.90 | $2,951.21 |
Oscar Health Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,862.09 | $1,862.09 | $1,862.09 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $7,585.78 | Facility | None | $954.99 | $1,995.26 | $7,585.78 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,659.59 Typical High $3,311.31 | Professional | None | $1,000.00 | $1,659.59 | $3,311.31 |
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 $524.81 Median $537.03 Typical High $660.69 | Professional | 52 · Reduced service | $524.81 | $537.03 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $213.80 Typical High $263.03 | Professional | 53 · Discontinued | $208.93 | $213.80 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $812.83 Typical High $977.24 | Professional | 54 · Surgery only | $794.33 | $812.83 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $162.18 Typical High $194.98 | Professional | 55 · Aftercare only | $158.49 | $162.18 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $107.15 Typical High $131.83 | Professional | 56 · Pre-op care only | $104.71 | $107.15 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $758.58 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $741.31 | $758.58 | $912.01 |
Where Georgia sits
The same service costs 4.6 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· 30th of 51
$1,549
WI $3,981TX $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.