How much rates vary
Facilitymedian $977 · 10th to 90th $501 to $6,761Professionalmedian $2,399 · 10th to 90th $1,585 to $4,365
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 $1,698.24 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,698.24 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $2,238.72 | Professional | None | $1,698.24 | $1,698.24 | $2,238.72 |
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 $1,412.54 Median $2,398.83 Typical High $4,073.80 | Professional | None | $1,412.54 | $2,398.83 | $4,073.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,148.15 Median $1,584.89 Typical High $2,691.53 | Professional | 62 · Two surgeons | $1,148.15 | $1,584.89 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $281.84 Median $436.52 Typical High $691.83 | Professional | 80 · Assistant surgeon | $281.84 | $436.52 | $691.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $251.19 Median $338.84 Typical High $602.56 | Professional | AS · PA/NP assist | $251.19 | $338.84 | $602.56 |
CareSource Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,584.89 | $1,584.89 | $1,584.89 |
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 $1,862.09 Median $2,691.53 Typical High $4,897.79 | Professional | None | $1,862.09 | $2,691.53 | $4,897.79 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,905.46 Median $2,290.87 Typical High $3,235.94 | Professional | None | $1,905.46 | $2,290.87 | $3,235.94 |
Oscar Health Setting Professional Modifier None Typical Low $1,548.82 Median $2,754.23 Typical High $2,754.23 | Professional | None | $1,548.82 | $2,754.23 | $2,754.23 |
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 $1,584.89 Median $2,818.38 Typical High $5,495.41 | Professional | None | $1,584.89 | $2,818.38 | $5,495.41 |
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 $851.14 Median $851.14 Typical High $1,122.02 | Professional | 52 · Reduced service | $851.14 | $851.14 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $338.84 Typical High $446.68 | Professional | 53 · Discontinued | $338.84 | $338.84 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,288.25 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,288.25 | $1,288.25 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $257.04 Typical High $331.13 | Professional | 55 · Aftercare only | $257.04 | $257.04 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $169.82 Typical High $223.87 | Professional | 56 · Pre-op care only | $169.82 | $169.82 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,202.26 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,202.26 | $1,548.82 |
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
$2,399
AK $5,888TX $1,096
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.