How much rates vary
Facilitymedian $813 · 10th to 90th $490 to $4,365Professionalmedian $794 · 10th to 90th $537 to $1,445
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 $562.34 Median $5,370.32 Typical High $7,943.28 | Facility | None | $562.34 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $741.31 | Professional | None | $562.34 | $562.34 | $741.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $512.86 Median $1,000.00 Typical High $4,570.88 | Facility | None | $512.86 | $1,000.00 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $501.19 Median $794.33 Typical High $1,348.96 | Professional | None | $501.19 | $794.33 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $380.19 Median $524.81 Typical High $912.01 | Professional | 62 · Two surgeons | $380.19 | $524.81 | $912.01 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $91.20 Median $144.54 Typical High $229.09 | Professional | 80 · Assistant surgeon | $91.20 | $144.54 | $229.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $81.28 Median $112.20 Typical High $199.53 | Professional | AS · PA/NP assist | $81.28 | $112.20 | $199.53 |
CareSource Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $758.58 Typical High $1,000.00 | Facility | None | $398.11 | $758.58 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $977.24 Typical High $1,584.89 | Professional | None | $616.60 | $977.24 | $1,584.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $660.69 Median $794.33 Typical High $1,698.24 | Professional | None | $660.69 | $794.33 | $1,698.24 |
Oscar Health Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | None | $724.44 | $724.44 | $724.44 |
United Setting Facility Modifier None Typical Low $501.19 Median $724.44 Typical High $3,548.13 | Facility | None | $501.19 | $724.44 | $3,548.13 |
United Setting Professional Modifier None Typical Low $524.81 Median $933.25 Typical High $1,819.70 | Professional | None | $524.81 | $933.25 | $1,819.70 |
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 $281.84 Median $281.84 Typical High $363.08 | Professional | 52 · Reduced service | $281.84 | $281.84 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $147.91 | Professional | 53 · Discontinued | $112.20 | $112.20 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $549.54 | Professional | 54 · Surgery only | $426.58 | $426.58 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $109.65 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $74.13 | Professional | 56 · Pre-op care only | $56.23 | $56.23 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $398.11 | $398.11 | $512.86 |
Where Georgia sits
The same service costs 5.5 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· 17th of 51
$794
AK $2,188TX $398
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.