How much rates vary
Facilitymedian $1,820 · 10th to 90th $708 to $6,026Professionalmedian $851 · 10th to 90th $617 to $1,514
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 $1,202.26 Median $5,370.32 Typical High $8,317.64 | Facility | None | $1,202.26 | $5,370.32 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $851.14 | Professional | None | $616.60 | $616.60 | $851.14 |
Anthem BCBS Setting Facility Modifier None Typical Low $660.69 Median $1,202.26 Typical High $4,570.88 | Facility | None | $660.69 | $1,202.26 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $616.60 Median $870.96 Typical High $1,380.38 | Professional | None | $616.60 | $870.96 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $407.38 Median $575.44 Typical High $977.24 | Professional | 62 · Two surgeons | $407.38 | $575.44 | $977.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $102.33 Median $154.88 Typical High $245.47 | Professional | 80 · Assistant surgeon | $102.33 | $154.88 | $245.47 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $123.03 Typical High $213.80 | Professional | AS · PA/NP assist | $91.20 | $123.03 | $213.80 |
CareSource Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,698.24 Typical High $2,344.23 | Facility | None | $741.31 | $1,698.24 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $977.24 Typical High $1,584.89 | Professional | None | $676.08 | $977.24 | $1,584.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $630.96 Median $776.25 Typical High $2,290.87 | Professional | None | $630.96 | $776.25 | $2,290.87 |
Oscar Health Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $2,884.03 Typical High $8,709.64 | Facility | None | $1,258.93 | $2,884.03 | $8,709.64 |
United Setting Professional Modifier None Typical Low $602.56 Median $1,023.29 Typical High $1,905.46 | Professional | None | $602.56 | $1,023.29 | $1,905.46 |
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 $309.03 Median $309.03 Typical High $380.19 | Professional | 52 · Reduced service | $309.03 | $309.03 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $154.88 | Professional | 53 · Discontinued | $123.03 | $123.03 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $457.09 Typical High $575.44 | Professional | 54 · Surgery only | $457.09 | $457.09 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $91.20 Typical High $114.82 | Professional | 55 · Aftercare only | $91.20 | $91.20 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $77.62 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $426.58 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $426.58 | $426.58 | $537.03 |
Where Georgia sits
The same service costs 6.5 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· 19th of 51
$891
AK $2,455TX $380
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.