How much rates vary
Facilitymedian $832 · 10th to 90th $501 to $5,370Professionalmedian $6,026 · 10th to 90th $3,890 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 $4,265.80 Median $5,370.32 Typical High $7,943.28 | Facility | None | $4,265.80 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $5,128.61 | Professional | None | $4,265.80 | $4,265.80 | $5,128.61 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $1,148.15 Typical High $5,754.40 | Facility | None | $575.44 | $1,148.15 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,548.13 Median $6,025.60 Typical High $8,709.64 | Professional | None | $3,548.13 | $6,025.60 | $8,709.64 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,818.38 Median $3,801.89 Typical High $6,760.83 | Professional | 62 · Two surgeons | $2,818.38 | $3,801.89 | $6,760.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $691.83 Median $1,047.13 Typical High $1,737.80 | Professional | 80 · Assistant surgeon | $691.83 | $1,047.13 | $1,737.80 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $616.60 Median $851.14 Typical High $1,513.56 | Professional | AS · PA/NP assist | $616.60 | $851.14 | $1,513.56 |
CareSource Setting Professional Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $3,981.07 | Professional | None | $3,981.07 | $3,981.07 | $3,981.07 |
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 $4,168.69 Median $6,760.83 Typical High $12,302.69 | Professional | None | $4,168.69 | $6,760.83 | $12,302.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4,786.30 Median $5,623.41 Typical High $5,754.40 | Professional | None | $4,786.30 | $5,623.41 | $5,754.40 |
Oscar Health Setting Professional Modifier None Typical Low $4,168.69 Median $4,168.69 Typical High $4,168.69 | Professional | None | $4,168.69 | $4,168.69 | $4,168.69 |
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 $3,890.45 Median $6,918.31 Typical High $13,803.84 | Professional | None | $3,890.45 | $6,918.31 | $13,803.84 |
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 $2,137.96 Median $2,137.96 Typical High $2,570.40 | Professional | 52 · Reduced service | $2,137.96 | $2,137.96 | $2,570.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $851.14 Median $851.14 Typical High $1,023.29 | Professional | 53 · Discontinued | $851.14 | $851.14 | $1,023.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,162.28 Median $3,162.28 Typical High $3,801.89 | Professional | 54 · Surgery only | $3,162.28 | $3,162.28 | $3,801.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $630.96 Median $630.96 Typical High $758.58 | Professional | 55 · Aftercare only | $630.96 | $630.96 | $758.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $426.58 Median $426.58 Typical High $512.86 | Professional | 56 · Pre-op care only | $426.58 | $426.58 | $512.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,951.21 Median $2,951.21 Typical High $3,548.13 | Professional | 78 · Unplanned return to OR | $2,951.21 | $2,951.21 | $3,548.13 |
Where Georgia sits
The same service costs 20.9 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· 17th of 51
$6,026
AK $14,125TX $676
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.