How much rates vary
Facilitymedian $1,122 · 10th to 90th $513 to $7,943Professionalmedian $1,380 · 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 $1,000.00 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,000.00 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,318.26 | Professional | None | $1,000.00 | $1,000.00 | $1,318.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $707.95 Median $2,290.87 Typical High $12,589.25 | Facility | None | $707.95 | $2,290.87 | $12,589.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $891.25 Median $1,412.54 Typical High $2,238.72 | Professional | None | $891.25 | $1,412.54 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $676.08 Median $954.99 Typical High $1,584.89 | Professional | 62 · Two surgeons | $676.08 | $954.99 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $269.15 Typical High $416.87 | Professional | 80 · Assistant surgeon | $204.17 | $269.15 | $416.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $208.93 Typical High $354.81 | Professional | AS · PA/NP assist | $151.36 | $208.93 | $354.81 |
CareSource Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | None | $933.25 | $933.25 | $933.25 |
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 $1,174.90 Median $1,778.28 Typical High $2,884.03 | Professional | None | $1,174.90 | $1,778.28 | $2,884.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,148.15 Median $1,412.54 Typical High $2,818.38 | Professional | None | $1,148.15 | $1,412.54 | $2,818.38 |
Oscar Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,288.25 | $1,288.25 | $1,288.25 |
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 $1,000.00 Median $1,698.24 Typical High $3,235.94 | Professional | None | $1,000.00 | $1,698.24 | $3,235.94 |
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 $501.19 Median $501.19 Typical High $645.65 | Professional | 52 · Reduced service | $501.19 | $501.19 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $257.04 | Professional | 53 · Discontinued | $199.53 | $199.53 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $977.24 | Professional | 54 · Surgery only | $741.31 | $741.31 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $194.98 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $128.82 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $912.01 |
Where Georgia sits
The same service costs 24.5 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· 24th of 51
$1,380
AK $4,074TX $166
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.