How much rates vary
Facilitymedian $1,148 · 10th to 90th $513 to $7,943Professionalmedian $2,042 · 10th to 90th $1,413 to $3,631
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 $1,445.44 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,445.44 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,905.46 | Professional | None | $1,445.44 | $1,445.44 | $1,905.46 |
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 $1,202.26 Median $2,041.74 Typical High $3,467.37 | Professional | None | $1,202.26 | $2,041.74 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $977.24 Median $1,348.96 Typical High $2,290.87 | Professional | 62 · Two surgeons | $977.24 | $1,348.96 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $239.88 Median $371.54 Typical High $588.84 | Professional | 80 · Assistant surgeon | $239.88 | $371.54 | $588.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $213.80 Median $295.12 Typical High $512.86 | Professional | AS · PA/NP assist | $213.80 | $295.12 | $512.86 |
CareSource Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,348.96 | $1,348.96 | $1,348.96 |
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 $1,621.81 Median $2,290.87 Typical High $4,168.69 | Professional | None | $1,621.81 | $2,290.87 | $4,168.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,659.59 Median $1,995.26 Typical High $2,511.89 | Professional | None | $1,659.59 | $1,995.26 | $2,511.89 |
Oscar Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
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 $1,380.38 Median $2,454.71 Typical High $4,677.35 | Professional | None | $1,380.38 | $2,454.71 | $4,677.35 |
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 $724.44 Median $724.44 Typical High $933.25 | Professional | 52 · Reduced service | $724.44 | $724.44 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $288.40 Typical High $380.19 | Professional | 53 · Discontinued | $288.40 | $288.40 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,071.52 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,071.52 | $1,071.52 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $213.80 Typical High $281.84 | Professional | 55 · Aftercare only | $213.80 | $213.80 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $144.54 Typical High $186.21 | Professional | 56 · Pre-op care only | $144.54 | $144.54 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,000.00 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,000.00 | $1,318.26 |
Where Georgia sits
The same service costs 5.0 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· 18th of 51
$2,042
AK $5,012TX $1,000
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.