How much rates vary
Facilitymedian $977 · 10th to 90th $501 to $6,761Professionalmedian $1,413 · 10th to 90th $955 to $2,512
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 $1,023.29 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,023.29 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,318.26 | Professional | None | $1,023.29 | $1,023.29 | $1,318.26 |
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 $831.76 Median $1,412.54 Typical High $2,398.83 | Professional | None | $831.76 | $1,412.54 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $912.01 Typical High $1,584.89 | Professional | 62 · Two surgeons | $645.65 | $912.01 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $263.03 Typical High $416.87 | Professional | 80 · Assistant surgeon | $186.21 | $263.03 | $416.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $194.98 Typical High $354.81 | Professional | AS · PA/NP assist | $144.54 | $194.98 | $354.81 |
CareSource Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | None | $912.01 | $912.01 | $912.01 |
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 $1,071.52 Median $1,584.89 Typical High $2,818.38 | Professional | None | $1,071.52 | $1,584.89 | $2,818.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,174.90 Median $1,348.96 Typical High $1,995.26 | Professional | None | $1,174.90 | $1,348.96 | $1,995.26 |
Oscar Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,621.81 Typical High $1,905.46 | Professional | None | $1,071.52 | $1,621.81 | $1,905.46 |
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 $891.25 Median $1,621.81 Typical High $3,162.28 | Professional | None | $891.25 | $1,621.81 | $3,162.28 |
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 $512.86 Median $512.86 Typical High $660.69 | Professional | 52 · Reduced service | $512.86 | $512.86 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $263.03 | Professional | 53 · Discontinued | $204.17 | $204.17 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $977.24 | Professional | 54 · Surgery only | $758.58 | $758.58 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $194.98 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $131.83 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $707.95 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $707.95 | $707.95 | $912.01 |
Where Georgia sits
The same service costs 4.9 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
$1,413
AK $3,548TX $724
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.