How much rates vary
Facilitymedian $977 · 10th to 90th $501 to $6,761Professionalmedian $1,660 · 10th to 90th $1,096 to $2,754
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 $1,174.90 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,174.90 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,548.82 | Professional | None | $1,174.90 | $1,174.90 | $1,548.82 |
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 $977.24 Median $1,659.59 Typical High $2,570.40 | Professional | None | $977.24 | $1,659.59 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $776.25 Median $1,096.48 Typical High $1,862.09 | Professional | 62 · Two surgeons | $776.25 | $1,096.48 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $288.40 Typical High $478.63 | Professional | 80 · Assistant surgeon | $194.98 | $288.40 | $478.63 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $229.09 Typical High $416.87 | Professional | AS · PA/NP assist | $169.82 | $229.09 | $416.87 |
CareSource Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,096.48 | $1,096.48 | $1,096.48 |
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 $1,288.25 Median $1,862.09 Typical High $3,388.44 | Professional | None | $1,288.25 | $1,862.09 | $3,388.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,318.26 Median $1,513.56 Typical High $2,344.23 | Professional | None | $1,318.26 | $1,513.56 | $2,344.23 |
Oscar Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | None | $1,047.13 | $1,047.13 | $1,047.13 |
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 $1,071.52 Median $1,905.46 Typical High $3,801.89 | Professional | None | $1,071.52 | $1,905.46 | $3,801.89 |
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 $588.84 Median $588.84 Typical High $776.25 | Professional | 52 · Reduced service | $588.84 | $588.84 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $309.03 | Professional | 53 · Discontinued | $234.42 | $234.42 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $891.25 Typical High $1,148.15 | Professional | 54 · Surgery only | $891.25 | $891.25 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $229.09 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $154.88 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $831.76 | $831.76 | $1,071.52 |
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· 17th of 51
$1,660
AK $4,266TX $794
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.