How much rates vary
Facilitymedian $851 · 10th to 90th $501 to $5,129Professionalmedian $1,622 · 10th to 90th $1,047 to $2,692
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 $1,174.90 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,174.90 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,380.38 | Professional | None | $1,174.90 | $1,174.90 | $1,380.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,258.93 Typical High $5,128.61 | Facility | None | $524.81 | $1,258.93 | $5,128.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,621.81 Typical High $2,570.40 | Professional | None | $977.24 | $1,621.81 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $1,047.13 Typical High $1,862.09 | Professional | 62 · Two surgeons | $758.58 | $1,047.13 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $281.84 Typical High $467.74 | Professional | 80 · Assistant surgeon | $190.55 | $281.84 | $467.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $229.09 Typical High $416.87 | Professional | AS · PA/NP assist | $169.82 | $229.09 | $416.87 |
CareSource Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,096.48 | $1,096.48 | $1,096.48 |
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 $1,148.15 Median $1,862.09 Typical High $3,311.31 | Professional | None | $1,148.15 | $1,862.09 | $3,311.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,318.26 Median $1,479.11 Typical High $1,698.24 | Professional | None | $1,318.26 | $1,479.11 | $1,698.24 |
Oscar Health Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | None | $776.25 | $776.25 | $776.25 |
United Setting Facility Modifier None Typical Low $501.19 Median $724.44 Typical High $3,548.13 | Facility | None | $501.19 | $724.44 | $3,548.13 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,905.46 Typical High $3,715.35 | Professional | None | $1,047.13 | $1,905.46 | $3,715.35 |
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 $588.84 Median $588.84 Typical High $691.83 | Professional | 52 · Reduced service | $588.84 | $588.84 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $281.84 | Professional | 53 · Discontinued | $234.42 | $234.42 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $870.96 Typical High $1,047.13 | Professional | 54 · Surgery only | $870.96 | $870.96 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $173.78 Typical High $208.93 | Professional | 55 · Aftercare only | $173.78 | $173.78 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $138.04 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $812.83 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $812.83 | $812.83 | $977.24 |
Where Georgia sits
The same service costs 5.5 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· 18th of 51
$1,622
AK $4,266TX $776
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.