How much rates vary
Facilitymedian $955 · 10th to 90th $501 to $6,607Professionalmedian $1,230 · 10th to 90th $813 to $2,138
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 $912.01 Median $5,370.32 Typical High $7,943.28 | Facility | None | $912.01 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,174.90 | Professional | None | $912.01 | $912.01 | $1,174.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,862.09 Typical High $7,943.28 | Facility | None | $588.84 | $1,862.09 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $794.33 Median $1,230.27 Typical High $1,995.26 | Professional | None | $794.33 | $1,230.27 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,348.96 Median $1,819.70 Typical High $3,019.95 | Professional | 50 · Both sides | $1,348.96 | $1,819.70 | $3,019.95 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $562.34 Median $776.25 Typical High $1,258.93 | Professional | 62 · Two surgeons | $562.34 | $776.25 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $194.98 Typical High $338.84 | Professional | 80 · Assistant surgeon | $141.25 | $194.98 | $338.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $169.82 Typical High $281.84 | Professional | AS · PA/NP assist | $125.89 | $169.82 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $549.54 Typical High $2,398.83 | Facility | None | $457.09 | $549.54 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,412.54 Typical High $2,454.71 | Professional | None | $1,000.00 | $1,412.54 | $2,454.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $812.83 Median $1,023.29 Typical High $3,019.95 | Professional | None | $812.83 | $1,023.29 | $3,019.95 |
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 $912.01 Median $1,348.96 Typical High $2,754.23 | Professional | None | $912.01 | $1,348.96 | $2,754.23 |
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 $457.09 Median $457.09 Typical High $537.03 | Professional | 52 · Reduced service | $457.09 | $457.09 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $218.78 | Professional | 53 · Discontinued | $181.97 | $181.97 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $676.08 Typical High $812.83 | Professional | 54 · Surgery only | $676.08 | $676.08 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $162.18 | Professional | 55 · Aftercare only | $134.90 | $134.90 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $107.15 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $630.96 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $630.96 | $630.96 | $758.58 |
Where Georgia sits
The same service costs 5.6 times more in Alaska than in Utah. 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· 22nd of 51
$1,230
AK $3,548UT $631
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.