How much rates vary
Facilitymedian $977 · 10th to 90th $501 to $6,761Professionalmedian $1,622 · 10th to 90th $1,072 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 $1,148.15 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,148.15 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,513.56 | Professional | None | $1,148.15 | $1,148.15 | $1,513.56 |
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 $954.99 Median $1,621.81 Typical High $2,511.89 | Professional | None | $954.99 | $1,621.81 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $776.25 Median $1,071.52 Typical High $1,819.70 | Professional | 62 · Two surgeons | $776.25 | $1,071.52 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $288.40 Typical High $467.74 | Professional | 80 · Assistant surgeon | $190.55 | $288.40 | $467.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $229.09 Typical High $407.38 | Professional | AS · PA/NP assist | $165.96 | $229.09 | $407.38 |
CareSource Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
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 $1,258.93 Median $1,819.70 Typical High $3,311.31 | Professional | None | $1,258.93 | $1,819.70 | $3,311.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,318.26 Median $1,479.11 Typical High $2,238.72 | Professional | None | $1,318.26 | $1,479.11 | $2,238.72 |
Oscar Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
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 $1,047.13 Median $1,862.09 Typical High $3,715.35 | Professional | None | $1,047.13 | $1,862.09 | $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 $575.44 Median $575.44 Typical High $758.58 | Professional | 52 · Reduced service | $575.44 | $575.44 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $302.00 | Professional | 53 · Discontinued | $234.42 | $234.42 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $870.96 Typical High $1,122.02 | Professional | 54 · Surgery only | $870.96 | $870.96 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $173.78 Typical High $223.87 | Professional | 55 · Aftercare only | $173.78 | $173.78 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $151.36 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $812.83 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $812.83 | $812.83 | $1,047.13 |
Where Georgia sits
The same service costs 5.6 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
$1,622
AK $4,266TX $759
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.