How much rates vary
Facilitymedian $1,514 · 10th to 90th $427 to $5,370Professionalmedian $692 · 10th to 90th $513 to $1,318
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 $630.96 Median $3,548.13 Typical High $7,585.78 | Facility | None | $630.96 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $1,318.26 | Professional | None | $512.86 | $512.86 | $1,318.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $1,000.00 Typical High $5,754.40 | Facility | None | $389.05 | $1,000.00 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $489.78 Median $691.83 Typical High $1,288.25 | Professional | None | $489.78 | $691.83 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $758.58 Median $1,047.13 Typical High $1,995.26 | Professional | 50 · Both sides | $758.58 | $1,047.13 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $323.59 Median $436.52 Typical High $831.76 | Professional | 62 · Two surgeons | $323.59 | $436.52 | $831.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $81.28 Median $117.49 Typical High $218.78 | Professional | 80 · Assistant surgeon | $81.28 | $117.49 | $218.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $70.79 Median $97.72 Typical High $186.21 | Professional | AS · PA/NP assist | $70.79 | $97.72 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $1,949.84 Typical High $2,454.71 | Facility | None | $398.11 | $1,949.84 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $794.33 Typical High $1,513.56 | Professional | None | $575.44 | $794.33 | $1,513.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $467.74 Median $588.84 Typical High $1,698.24 | Professional | None | $467.74 | $588.84 | $1,698.24 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,479.11 Typical High $5,011.87 | Facility | None | $851.14 | $1,479.11 | $5,011.87 |
United Setting Professional Modifier None Typical Low $524.81 Median $758.58 Typical High $1,412.54 | Professional | None | $524.81 | $758.58 | $1,412.54 |
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 $257.04 Median $257.04 Typical High $331.13 | Professional | 52 · Reduced service | $257.04 | $257.04 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $131.83 | Professional | 53 · Discontinued | $102.33 | $102.33 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $389.05 Typical High $501.19 | Professional | 54 · Surgery only | $389.05 | $389.05 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $100.00 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $66.07 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $363.08 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $363.08 | $363.08 | $467.74 |
Where Georgia sits
The same service costs 5.5 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· 27th of 51
$776
AK $2,042UT $372
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.