How much rates vary
Facilitymedian $977 · 10th to 90th $501 to $6,761Professionalmedian $1,820 · 10th to 90th $1,230 to $3,311
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 $1,318.26 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,318.26 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,698.24 | Professional | None | $1,318.26 | $1,318.26 | $1,698.24 |
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 $1,096.48 Median $1,819.70 Typical High $3,162.28 | Professional | None | $1,096.48 | $1,819.70 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $851.14 Median $1,202.26 Typical High $2,089.30 | Professional | 62 · Two surgeons | $851.14 | $1,202.26 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $331.13 Typical High $537.03 | Professional | 80 · Assistant surgeon | $218.78 | $331.13 | $537.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $257.04 Typical High $467.74 | Professional | AS · PA/NP assist | $190.55 | $257.04 | $467.74 |
CareSource Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,230.27 | $1,230.27 | $1,230.27 |
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 $1,412.54 Median $2,089.30 Typical High $3,715.35 | Professional | None | $1,412.54 | $2,089.30 | $3,715.35 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,479.11 Median $1,778.28 Typical High $2,691.53 | Professional | None | $1,479.11 | $1,778.28 | $2,691.53 |
Oscar Health Setting Professional Modifier None Typical Low $1,122.02 Median $2,089.30 Typical High $2,089.30 | Professional | None | $1,122.02 | $2,089.30 | $2,089.30 |
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 $1,202.26 Median $2,137.96 Typical High $4,265.80 | Professional | None | $1,202.26 | $2,137.96 | $4,265.80 |
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 $660.69 Median $660.69 Typical High $851.14 | Professional | 52 · Reduced service | $660.69 | $660.69 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $338.84 | Professional | 53 · Discontinued | $263.03 | $263.03 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $977.24 Typical High $1,288.25 | Professional | 54 · Surgery only | $977.24 | $977.24 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $257.04 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $169.82 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $1,202.26 |
Where Georgia sits
The same service costs 5.4 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
$1,820
AK $4,571TX $851
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.