How much rates vary
Facilitymedian $3,236 · 10th to 90th $851 to $8,913Professionalmedian $1,072 · 10th to 90th $724 to $1,995
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 $1,778.28 Median $7,079.46 Typical High $15,488.17 | Facility | None | $1,778.28 | $7,079.46 | $15,488.17 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,047.13 | Professional | None | $758.58 | $758.58 | $1,047.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $794.33 Median $1,584.89 Typical High $8,912.51 | Facility | None | $794.33 | $1,584.89 | $8,912.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $645.65 Median $1,071.52 Typical High $1,905.46 | Professional | None | $645.65 | $1,071.52 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $512.86 Median $724.44 Typical High $1,230.27 | Professional | 62 · Two surgeons | $512.86 | $724.44 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $199.53 Typical High $323.59 | Professional | 80 · Assistant surgeon | $125.89 | $199.53 | $323.59 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $154.88 Typical High $275.42 | Professional | AS · PA/NP assist | $112.20 | $154.88 | $275.42 |
CareSource Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | None | $724.44 | $724.44 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $3,548.13 Typical High $4,677.35 | Facility | None | $831.76 | $3,548.13 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,318.26 Typical High $2,187.76 | Professional | None | $831.76 | $1,318.26 | $2,187.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $870.96 Median $1,071.52 Typical High $2,691.53 | Professional | None | $870.96 | $1,071.52 | $2,691.53 |
Oscar Health Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | None | $870.96 | $870.96 | $870.96 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $3,715.35 Typical High $9,549.93 | Facility | None | $1,513.56 | $3,715.35 | $9,549.93 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,288.25 Typical High $2,454.71 | Professional | None | $724.44 | $1,288.25 | $2,454.71 |
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 $380.19 Median $380.19 Typical High $501.19 | Professional | 52 · Reduced service | $380.19 | $380.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $199.53 | Professional | 53 · Discontinued | $151.36 | $151.36 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $575.44 Typical High $741.31 | Professional | 54 · Surgery only | $575.44 | $575.44 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $151.36 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $100.00 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $537.03 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $537.03 | $537.03 | $691.83 |
Where Georgia sits
The same service costs 25.1 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· 20th of 51
$1,096
AK $3,090TX $123
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.