How much rates vary
Facilitymedian $1,288 · 10th to 90th $513 to $9,120Professionalmedian $1,738 · 10th to 90th $1,047 to $3,236
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 $1,000.00 Median $7,079.46 Typical High $12,302.69 | Facility | None | $1,000.00 | $7,079.46 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,348.96 Typical High $3,467.37 | Professional | None | $1,000.00 | $1,348.96 | $3,467.37 |
Ambetter Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,548.82 | $1,548.82 | $1,548.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $831.76 Median $2,570.40 Typical High $11,220.18 | Facility | None | $831.76 | $2,570.40 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $1,778.28 Typical High $3,019.95 | Professional | None | $1,096.48 | $1,778.28 | $3,019.95 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $812.83 Median $1,174.90 Typical High $2,089.30 | Professional | 62 · Two surgeons | $812.83 | $1,174.90 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $316.23 Typical High $537.03 | Professional | 80 · Assistant surgeon | $208.93 | $316.23 | $537.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $295.12 Typical High $467.74 | Professional | AS · PA/NP assist | $181.97 | $295.12 | $467.74 |
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 $1,288.25 Median $1,995.26 Typical High $3,388.44 | Professional | None | $1,288.25 | $1,995.26 | $3,388.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,122.02 Median $1,348.96 Typical High $2,691.53 | Professional | None | $1,122.02 | $1,348.96 | $2,691.53 |
Oscar Health Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,949.84 | $1,949.84 | $1,949.84 |
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 $1,288.25 Median $1,862.09 Typical High $2,951.21 | Professional | None | $1,288.25 | $1,862.09 | $2,951.21 |
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 $501.19 Median $501.19 Typical High $691.83 | Professional | 52 · Reduced service | $501.19 | $501.19 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $275.42 | Professional | 53 · Discontinued | $204.17 | $204.17 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $1,023.29 | Professional | 54 · Surgery only | $758.58 | $758.58 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $204.17 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $138.04 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $707.95 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $707.95 | $707.95 | $954.99 |
Where Georgia sits
The same service costs 7.1 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· 18th of 51
$1,738
AK $5,012TX $708
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.