How much rates vary
Facilitymedian $1,148 · 10th to 90th $513 to $7,943Professionalmedian $5,012 · 10th to 90th $2,951 to $9,120
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 $3,548.13 Median $5,370.32 Typical High $7,943.28 | Facility | None | $3,548.13 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $4,677.35 | Professional | None | $3,548.13 | $3,548.13 | $4,677.35 |
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 $2,951.21 Median $5,011.87 Typical High $8,709.64 | Professional | None | $2,951.21 | $5,011.87 | $8,709.64 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,137.96 Median $3,235.94 Typical High $5,623.41 | Professional | 62 · Two surgeons | $2,137.96 | $3,235.94 | $5,623.41 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $501.19 Median $891.25 Typical High $1,445.44 | Professional | 80 · Assistant surgeon | $501.19 | $891.25 | $1,445.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $457.09 Median $707.95 Typical High $1,258.93 | Professional | AS · PA/NP assist | $457.09 | $707.95 | $1,258.93 |
CareSource Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,388.44 | Professional | None | $3,388.44 | $3,388.44 | $3,388.44 |
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 $3,890.45 Median $5,888.44 Typical High $11,220.18 | Professional | None | $3,890.45 | $5,888.44 | $11,220.18 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,981.07 Median $4,570.88 Typical High $6,025.60 | Professional | None | $3,981.07 | $4,570.88 | $6,025.60 |
Oscar Health Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $5,754.40 | Professional | None | $2,630.27 | $2,630.27 | $5,754.40 |
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 $3,090.30 Median $5,888.44 Typical High $11,748.98 | Professional | None | $3,090.30 | $5,888.44 | $11,748.98 |
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 $1,778.28 Median $1,778.28 Typical High $2,344.23 | Professional | 52 · Reduced service | $1,778.28 | $1,778.28 | $2,344.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $707.95 Median $707.95 Typical High $933.25 | Professional | 53 · Discontinued | $707.95 | $707.95 | $933.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,691.53 Median $2,691.53 Typical High $3,467.37 | Professional | 54 · Surgery only | $2,691.53 | $2,691.53 | $3,467.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $537.03 Median $537.03 Typical High $707.95 | Professional | 55 · Aftercare only | $537.03 | $537.03 | $707.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $354.81 Median $354.81 Typical High $467.74 | Professional | 56 · Pre-op care only | $354.81 | $354.81 | $467.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,511.89 Median $2,511.89 Typical High $3,235.94 | Professional | 78 · Unplanned return to OR | $2,511.89 | $2,511.89 | $3,235.94 |
Where Georgia sits
The same service costs 21.9 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
$5,012
AK $12,303TX $562
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.