How much rates vary
Facilitymedian $977 · 10th to 90th $501 to $6,761Professionalmedian $1,995 · 10th to 90th $1,318 to $3,236
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 $1,412.54 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,412.54 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,862.09 | Professional | None | $1,412.54 | $1,412.54 | $1,862.09 |
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 $1,174.90 Median $1,995.26 Typical High $3,090.30 | Professional | None | $1,174.90 | $1,995.26 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $933.25 Median $1,318.26 Typical High $2,238.72 | Professional | 62 · Two surgeons | $933.25 | $1,318.26 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $234.42 Median $354.81 Typical High $575.44 | Professional | 80 · Assistant surgeon | $234.42 | $354.81 | $575.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $275.42 Typical High $501.19 | Professional | AS · PA/NP assist | $204.17 | $275.42 | $501.19 |
CareSource Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
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 $1,548.82 Median $2,238.72 Typical High $4,073.80 | Professional | None | $1,548.82 | $2,238.72 | $4,073.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,584.89 Median $1,905.46 Typical High $3,019.95 | Professional | None | $1,584.89 | $1,905.46 | $3,019.95 |
Oscar Health Setting Professional Modifier None Typical Low $1,318.26 Median $2,290.87 Typical High $2,570.40 | Professional | None | $1,318.26 | $2,290.87 | $2,570.40 |
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 $1,288.25 Median $2,290.87 Typical High $4,570.88 | Professional | None | $1,288.25 | $2,290.87 | $4,570.88 |
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 $707.95 Median $707.95 Typical High $912.01 | Professional | 52 · Reduced service | $707.95 | $707.95 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $371.54 | Professional | 53 · Discontinued | $281.84 | $281.84 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,047.13 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,047.13 | $1,047.13 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $213.80 Typical High $275.42 | Professional | 55 · Aftercare only | $213.80 | $213.80 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $186.21 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,000.00 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,000.00 | $1,288.25 |
Where Georgia sits
The same service costs 5.2 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· 16th of 51
$1,995
AK $4,898TX $933
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.