How much rates vary
Facilitymedian $1,148 · 10th to 90th $513 to $7,413Professionalmedian $1,778 · 10th to 90th $1,202 to $2,951
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 $1,380.38 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,380.38 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,380.38 Typical High $1,659.59 | Professional | None | $1,348.96 | $1,380.38 | $1,659.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $707.95 Median $2,041.74 Typical High $9,772.37 | Facility | None | $707.95 | $2,041.74 | $9,772.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $1,819.70 Typical High $2,818.38 | Professional | None | $1,148.15 | $1,819.70 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,995.26 Median $3,019.95 Typical High $4,265.80 | Professional | 50 · Both sides | $1,995.26 | $3,019.95 | $4,265.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $870.96 Median $1,258.93 Typical High $1,778.28 | Professional | 62 · Two surgeons | $870.96 | $1,258.93 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $346.74 Typical High $467.74 | Professional | 80 · Assistant surgeon | $208.93 | $346.74 | $467.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $281.84 Typical High $398.11 | Professional | AS · PA/NP assist | $181.97 | $281.84 | $398.11 |
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 $1,412.54 Median $2,089.30 Typical High $4,073.80 | Professional | None | $1,412.54 | $2,089.30 | $4,073.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,288.25 Median $1,412.54 Typical High $2,041.74 | Professional | None | $1,288.25 | $1,412.54 | $2,041.74 |
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 $1,288.25 Median $2,089.30 Typical High $4,168.69 | Professional | None | $1,288.25 | $2,089.30 | $4,168.69 |
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 $676.08 Median $691.83 Typical High $794.33 | Professional | 52 · Reduced service | $676.08 | $691.83 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $275.42 Typical High $316.23 | Professional | 53 · Discontinued | $269.15 | $275.42 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,023.29 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,000.00 | $1,023.29 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $204.17 Typical High $239.88 | Professional | 55 · Aftercare only | $204.17 | $204.17 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $138.04 Typical High $158.49 | Professional | 56 · Pre-op care only | $134.90 | $138.04 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $954.99 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $933.25 | $954.99 | $1,122.02 |
Where Georgia sits
The same service costs 5.4 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· 30th of 51
$1,698
AK $4,898TX $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.