How much rates vary
Facilitymedian $977 · 10th to 90th $501 to $6,310Professionalmedian $5,495 · 10th to 90th $3,631 to $9,772
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 $3,890.45 Median $5,370.32 Typical High $7,943.28 | Facility | None | $3,890.45 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $4,677.35 | Professional | None | $3,890.45 | $3,890.45 | $4,677.35 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,778.28 Typical High $7,244.36 | Facility | None | $588.84 | $1,778.28 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,235.94 Median $5,495.41 Typical High $9,332.54 | Professional | None | $3,235.94 | $5,495.41 | $9,332.54 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,570.40 Median $3,548.13 Typical High $6,165.95 | Professional | 62 · Two surgeons | $2,570.40 | $3,548.13 | $6,165.95 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $645.65 Median $954.99 Typical High $1,584.89 | Professional | 80 · Assistant surgeon | $645.65 | $954.99 | $1,584.89 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $562.34 Median $758.58 Typical High $1,380.38 | Professional | AS · PA/NP assist | $562.34 | $758.58 | $1,380.38 |
CareSource Setting Professional Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Professional | None | $3,630.78 | $3,630.78 | $3,630.78 |
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 $3,801.89 Median $6,165.95 Typical High $11,220.18 | Professional | None | $3,801.89 | $6,165.95 | $11,220.18 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4,365.16 Median $5,128.61 Typical High $5,623.41 | Professional | None | $4,365.16 | $5,128.61 | $5,623.41 |
Oscar Health Setting Professional Modifier None Typical Low $2,754.23 Median $6,309.57 Typical High $6,918.31 | Professional | None | $2,754.23 | $6,309.57 | $6,918.31 |
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 $3,630.78 Median $6,309.57 Typical High $12,589.25 | Professional | None | $3,630.78 | $6,309.57 | $12,589.25 |
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 $1,949.84 Median $1,949.84 Typical High $2,344.23 | Professional | 52 · Reduced service | $1,949.84 | $1,949.84 | $2,344.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $776.25 Median $776.25 Typical High $933.25 | Professional | 53 · Discontinued | $776.25 | $776.25 | $933.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,884.03 Median $2,884.03 Typical High $3,467.37 | Professional | 54 · Surgery only | $2,884.03 | $2,884.03 | $3,467.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $588.84 Median $588.84 Typical High $691.83 | Professional | 55 · Aftercare only | $588.84 | $588.84 | $691.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $389.05 Median $389.05 Typical High $467.74 | Professional | 56 · Pre-op care only | $389.05 | $389.05 | $467.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,691.53 Median $2,691.53 Typical High $3,235.94 | Professional | 78 · Unplanned return to OR | $2,691.53 | $2,691.53 | $3,235.94 |
Where Georgia sits
The same service costs 21.9 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
$5,495
AK $13,183TX $603
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.