How much rates vary
Facilitymedian $977 · 10th to 90th $501 to $6,761Professionalmedian $1,905 · 10th to 90th $1,259 to $3,467
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 $1,348.96 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,348.96 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,778.28 | Professional | None | $1,348.96 | $1,348.96 | $1,778.28 |
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 $1,122.02 Median $1,905.46 Typical High $3,235.94 | Professional | None | $1,122.02 | $1,905.46 | $3,235.94 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $912.01 Median $1,258.93 Typical High $2,137.96 | Professional | 62 · Two surgeons | $912.01 | $1,258.93 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $338.84 Typical High $549.54 | Professional | 80 · Assistant surgeon | $223.87 | $338.84 | $549.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $263.03 Typical High $478.63 | Professional | AS · PA/NP assist | $194.98 | $263.03 | $478.63 |
CareSource Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
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 $1,479.11 Median $2,137.96 Typical High $3,890.45 | Professional | None | $1,479.11 | $2,137.96 | $3,890.45 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,513.56 Median $1,737.80 Typical High $2,691.53 | Professional | None | $1,513.56 | $1,737.80 | $2,691.53 |
Oscar Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
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 $4,365.16 | Professional | None | $1,230.27 | $2,187.76 | $4,365.16 |
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 $676.08 Median $676.08 Typical High $891.25 | Professional | 52 · Reduced service | $676.08 | $676.08 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $354.81 | Professional | 53 · Discontinued | $269.15 | $269.15 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,023.29 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,023.29 | $1,023.29 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $204.17 Typical High $263.03 | Professional | 55 · Aftercare only | $204.17 | $204.17 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $177.83 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $954.99 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $954.99 | $954.99 | $1,230.27 |
Where Georgia sits
The same service costs 5.4 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
$1,905
AK $4,677TX $871
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.