How much rates vary
Facilitymedian $1,288 · 10th to 90th $525 to $11,749Professionalmedian $1,096 · 10th to 90th $741 to $1,862
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 $1,202.26 Median $7,943.28 Typical High $15,488.17 | Facility | None | $1,202.26 | $7,943.28 | $15,488.17 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $794.33 Typical High $1,318.26 | Professional | None | $776.25 | $794.33 | $1,318.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $831.76 Median $2,754.23 Typical High $15,135.61 | Facility | None | $831.76 | $2,754.23 | $15,135.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $691.83 Median $1,096.48 Typical High $1,778.28 | Professional | None | $691.83 | $1,096.48 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $524.81 Median $741.31 Typical High $1,230.27 | Professional | 62 · Two surgeons | $524.81 | $741.31 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $199.53 Typical High $323.59 | Professional | 80 · Assistant surgeon | $131.83 | $199.53 | $323.59 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $117.49 Median $158.49 Typical High $275.42 | Professional | AS · PA/NP assist | $117.49 | $158.49 | $275.42 |
CareSource Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | None | $724.44 | $724.44 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $549.54 Typical High $2,691.53 | Facility | None | $501.19 | $549.54 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,348.96 Typical High $2,238.72 | Professional | None | $851.14 | $1,348.96 | $2,238.72 |
Kaiser Permanente Setting Professional Modifier None Typical Low $870.96 Median $1,071.52 Typical High $2,137.96 | Professional | None | $870.96 | $1,071.52 | $2,137.96 |
Oscar Health Setting Professional Modifier None Typical Low $831.76 Median $1,380.38 Typical High $1,862.09 | Professional | None | $831.76 | $1,380.38 | $1,862.09 |
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 $741.31 Median $1,288.25 Typical High $2,511.89 | Professional | None | $741.31 | $1,288.25 | $2,511.89 |
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 $389.05 Median $389.05 Typical High $501.19 | Professional | 52 · Reduced service | $389.05 | $389.05 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $204.17 | Professional | 53 · Discontinued | $154.88 | $154.88 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $575.44 Typical High $758.58 | Professional | 54 · Surgery only | $575.44 | $575.44 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $151.36 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $102.33 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $537.03 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $537.03 | $537.03 | $707.95 |
Where Georgia sits
The same service costs 5.9 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· 19th of 51
$1,096
AK $3,162TX $537
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.