How much rates vary
Facilitymedian $1,000 · 10th to 90th $501 to $10,000Professionalmedian $2,512 · 10th to 90th $1,698 to $4,169
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 $1,819.70 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,819.70 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $2,344.23 | Professional | None | $1,819.70 | $1,819.70 | $2,344.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,905.46 Typical High $13,803.84 | Facility | None | $588.84 | $1,905.46 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,513.56 Median $2,511.89 Typical High $3,981.07 | Professional | None | $1,513.56 | $2,511.89 | $3,981.07 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,202.26 Median $1,659.59 Typical High $2,884.03 | Professional | 62 · Two surgeons | $1,202.26 | $1,659.59 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $302.00 Median $457.09 Typical High $741.31 | Professional | 80 · Assistant surgeon | $302.00 | $457.09 | $741.31 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $263.03 Median $354.81 Typical High $645.65 | Professional | AS · PA/NP assist | $263.03 | $354.81 | $645.65 |
CareSource Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,698.24 | $1,698.24 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $549.54 Typical High $4,365.16 | Facility | None | $446.68 | $549.54 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $1,949.84 Median $2,884.03 Typical High $5,128.61 | Professional | None | $1,949.84 | $2,884.03 | $5,128.61 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,995.26 Median $2,454.71 Typical High $3,890.45 | Professional | None | $1,995.26 | $2,454.71 | $3,890.45 |
Oscar Health Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,737.80 | $1,737.80 | $1,737.80 |
United Setting Facility Modifier None Typical Low $371.54 Median $645.65 Typical High $6,165.95 | Facility | None | $371.54 | $645.65 | $6,165.95 |
United Setting Professional Modifier None Typical Low $1,659.59 Median $2,951.21 Typical High $5,888.44 | Professional | None | $1,659.59 | $2,951.21 | $5,888.44 |
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 $912.01 Median $912.01 Typical High $1,174.90 | Professional | 52 · Reduced service | $912.01 | $912.01 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $363.08 Typical High $467.74 | Professional | 53 · Discontinued | $363.08 | $363.08 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,348.96 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,348.96 | $1,348.96 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $269.15 Typical High $354.81 | Professional | 55 · Aftercare only | $269.15 | $269.15 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $181.97 Typical High $234.42 | Professional | 56 · Pre-op care only | $181.97 | $181.97 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,258.93 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,258.93 | $1,659.59 |
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· 19th of 51
$2,512
AK $6,310TX $1,175
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.