How much rates vary
Facilitymedian $977 · 10th to 90th $501 to $6,761Professionalmedian $3,020 · 10th to 90th $1,950 to $6,607
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 $1,949.84 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,949.84 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,949.84 Median $2,041.74 Typical High $2,754.23 | Professional | None | $1,949.84 | $2,041.74 | $2,754.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,862.09 Typical High $8,128.31 | Facility | None | $588.84 | $1,862.09 | $8,128.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,995.26 Median $2,818.38 Typical High $6,918.31 | Professional | None | $1,995.26 | $2,818.38 | $6,918.31 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,288.25 Median $2,754.23 Typical High $8,709.64 | Professional | 62 · Two surgeons | $1,288.25 | $2,754.23 | $8,709.64 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $331.13 Median $691.83 Typical High $2,238.72 | Professional | 80 · Assistant surgeon | $331.13 | $691.83 | $2,238.72 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $288.40 Median $602.56 Typical High $1,949.84 | Professional | AS · PA/NP assist | $288.40 | $602.56 | $1,949.84 |
CareSource Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,819.70 | $1,819.70 | $1,819.70 |
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 $2,290.87 Median $3,715.35 Typical High $6,456.54 | Professional | None | $2,290.87 | $3,715.35 | $6,456.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,290.87 Median $3,981.07 Typical High $4,677.35 | Professional | None | $2,290.87 | $3,981.07 | $4,677.35 |
Oscar Health Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,548.82 | $1,548.82 | $1,548.82 |
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 $2,187.76 Median $4,265.80 Typical High $8,511.38 | Professional | None | $2,187.76 | $4,265.80 | $8,511.38 |
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 $977.24 Median $1,023.29 Typical High $1,288.25 | Professional | 52 · Reduced service | $977.24 | $1,023.29 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $407.38 Typical High $512.86 | Professional | 53 · Discontinued | $389.05 | $407.38 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,513.56 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,479.11 | $1,513.56 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $302.00 Typical High $389.05 | Professional | 55 · Aftercare only | $295.12 | $302.00 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $204.17 Typical High $257.04 | Professional | 56 · Pre-op care only | $194.98 | $204.17 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,412.54 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,412.54 | $1,778.28 |
Where Georgia sits
The same service costs 9.8 times more in Alaska than in Kentucky. 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· 20th of 51
$2,884
AK $8,511KY $871
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.