How much rates vary
Facilitymedian $1,122 · 10th to 90th $513 to $7,943Professionalmedian $1,479 · 10th to 90th $1,023 to $2,570
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 $1,122.02 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,122.02 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,412.54 | Professional | None | $1,122.02 | $1,122.02 | $1,412.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $707.95 Median $2,290.87 Typical High $10,715.19 | Facility | None | $707.95 | $2,290.87 | $10,715.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,513.56 Typical High $2,398.83 | Professional | None | $977.24 | $1,513.56 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,621.81 Median $2,290.87 Typical High $3,715.35 | Professional | 50 · Both sides | $1,621.81 | $2,290.87 | $3,715.35 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $676.08 Median $954.99 Typical High $1,548.82 | Professional | 62 · Two surgeons | $676.08 | $954.99 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $239.88 Typical High $416.87 | Professional | 80 · Assistant surgeon | $173.78 | $239.88 | $416.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $213.80 Typical High $346.74 | Professional | AS · PA/NP assist | $151.36 | $213.80 | $346.74 |
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 $1,230.27 Median $1,621.81 Typical High $3,019.95 | Professional | None | $1,230.27 | $1,621.81 | $3,019.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,071.52 Median $1,318.26 Typical High $2,137.96 | Professional | None | $1,071.52 | $1,318.26 | $2,137.96 |
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 $1,023.29 Median $1,548.82 Typical High $3,388.44 | Professional | None | $1,023.29 | $1,548.82 | $3,388.44 |
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 $562.34 Median $562.34 Typical High $660.69 | Professional | 52 · Reduced service | $562.34 | $562.34 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $263.03 | Professional | 53 · Discontinued | $223.87 | $223.87 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $831.76 Typical High $1,000.00 | Professional | 54 · Surgery only | $831.76 | $831.76 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $199.53 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $131.83 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $776.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $776.25 | $776.25 | $933.25 |
Where Georgia sits
The same service costs 6.6 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
$1,479
AK $4,365TX $661
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.