How much rates vary
Facilitymedian $977 · 10th to 90th $501 to $6,761Professionalmedian $1,820 · 10th to 90th $1,202 to $3,162
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 $1,318.26 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,318.26 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,737.80 | Professional | None | $1,318.26 | $1,318.26 | $1,737.80 |
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 $1,096.48 Median $1,949.84 Typical High $3,090.30 | Professional | None | $1,096.48 | $1,949.84 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $891.25 Median $1,230.27 Typical High $2,187.76 | Professional | 62 · Two surgeons | $891.25 | $1,230.27 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $331.13 Typical High $537.03 | Professional | 80 · Assistant surgeon | $218.78 | $331.13 | $537.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $263.03 Typical High $467.74 | Professional | AS · PA/NP assist | $194.98 | $263.03 | $467.74 |
CareSource Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,230.27 | $1,230.27 | $1,230.27 |
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 $1,445.44 Median $2,089.30 Typical High $3,801.89 | Professional | None | $1,445.44 | $2,089.30 | $3,801.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,479.11 Median $1,698.24 Typical High $2,344.23 | Professional | None | $1,479.11 | $1,698.24 | $2,344.23 |
Oscar Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | None | $1,174.90 | $1,174.90 | $1,174.90 |
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 $1,230.27 Median $2,187.76 Typical High $4,265.80 | Professional | None | $1,230.27 | $2,187.76 | $4,265.80 |
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 $660.69 Median $660.69 Typical High $870.96 | Professional | 52 · Reduced service | $660.69 | $660.69 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $346.74 | Professional | 53 · Discontinued | $269.15 | $269.15 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,000.00 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,000.00 | $1,000.00 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $257.04 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $173.78 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $933.25 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $933.25 | $933.25 | $1,202.26 |
Where Georgia sits
The same service costs 5.0 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
$1,820
AK $4,467TX $891
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.