How much rates vary
Facilitymedian $3,236 · 10th to 90th $1,202 to $10,000Professionalmedian $603 · 10th to 90th $398 to $1,122
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 $1,659.59 Median $7,244.36 Typical High $15,488.17 | Facility | None | $1,659.59 | $7,244.36 | $15,488.17 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $501.19 Typical High $1,445.44 | Professional | None | $446.68 | $501.19 | $1,445.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,096.48 Median $1,949.84 Typical High $10,000.00 | Facility | None | $1,096.48 | $1,949.84 | $10,000.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $389.05 Median $602.56 Typical High $1,023.29 | Professional | None | $389.05 | $602.56 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $645.65 Median $891.25 Typical High $1,659.59 | Professional | 50 · Both sides | $645.65 | $891.25 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $275.42 Median $380.19 Typical High $707.95 | Professional | 62 · Two surgeons | $275.42 | $380.19 | $707.95 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $67.61 Median $95.50 Typical High $181.97 | Professional | 80 · Assistant surgeon | $67.61 | $95.50 | $181.97 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $61.66 Median $83.18 Typical High $158.49 | Professional | AS · PA/NP assist | $61.66 | $83.18 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $1,513.56 Median $3,548.13 Typical High $4,897.79 | Facility | None | $1,513.56 | $3,548.13 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $660.69 Typical High $1,202.26 | Professional | None | $489.78 | $660.69 | $1,202.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $407.38 Median $501.19 Typical High $1,258.93 | Professional | None | $407.38 | $501.19 | $1,258.93 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $3,715.35 Typical High $9,549.93 | Facility | None | $1,513.56 | $3,715.35 | $9,549.93 |
United Setting Professional Modifier None Typical Low $446.68 Median $630.96 Typical High $1,202.26 | Professional | None | $446.68 | $630.96 | $1,202.26 |
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 $223.87 Median $223.87 Typical High $281.84 | Professional | 52 · Reduced service | $223.87 | $223.87 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $89.13 Typical High $114.82 | Professional | 53 · Discontinued | $89.13 | $89.13 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $331.13 Typical High $426.58 | Professional | 54 · Surgery only | $331.13 | $331.13 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $66.07 Typical High $85.11 | Professional | 55 · Aftercare only | $66.07 | $66.07 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $44.67 Typical High $57.54 | Professional | 56 · Pre-op care only | $44.67 | $44.67 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $309.03 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $309.03 | $309.03 | $398.11 |
Where Georgia sits
The same service costs 9.5 times more in Oklahoma 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
$708
OK $3,236UT $339
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.