How much rates vary
Facilitymedian $832 · 10th to 90th $490 to $5,012Professionalmedian $2,188 · 10th to 90th $1,445 to $3,631
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 $1,698.24 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,698.24 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $1,698.24 Typical High $2,511.89 | Professional | None | $1,659.59 | $1,698.24 | $2,511.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,096.48 Typical High $5,495.41 | Facility | None | $524.81 | $1,096.48 | $5,495.41 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,412.54 Median $2,187.76 Typical High $3,467.37 | Professional | None | $1,412.54 | $2,187.76 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,000.00 Median $1,513.56 Typical High $2,238.72 | Professional | 62 · Two surgeons | $1,000.00 | $1,513.56 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $251.19 Median $416.87 Typical High $575.44 | Professional | 80 · Assistant surgeon | $251.19 | $416.87 | $575.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $223.87 Median $338.84 Typical High $489.78 | Professional | AS · PA/NP assist | $223.87 | $338.84 | $489.78 |
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 $1,737.80 Median $2,454.71 Typical High $5,011.87 | Professional | None | $1,737.80 | $2,454.71 | $5,011.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,584.89 Median $1,819.70 Typical High $3,162.28 | Professional | None | $1,584.89 | $1,819.70 | $3,162.28 |
Oscar Health Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,884.03 | $2,884.03 | $2,884.03 |
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 $1,584.89 Median $2,570.40 Typical High $5,128.61 | Professional | None | $1,584.89 | $2,570.40 | $5,128.61 |
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 $831.76 Median $851.14 Typical High $1,023.29 | Professional | 52 · Reduced service | $831.76 | $851.14 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $338.84 Typical High $407.38 | Professional | 53 · Discontinued | $331.13 | $338.84 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,258.93 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,230.27 | $1,258.93 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $251.19 Typical High $309.03 | Professional | 55 · Aftercare only | $245.47 | $251.19 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $169.82 Typical High $204.17 | Professional | 56 · Pre-op care only | $165.96 | $169.82 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,174.90 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,174.90 | $1,445.44 |
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· 29th of 51
$2,089
AK $6,026TX $1,072
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.