How much rates vary
Facilitymedian $3,020 · 10th to 90th $1,023 to $9,550Professionalmedian $1,820 · 10th to 90th $1,096 to $3,162
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 $1,202.26 Median $6,309.57 Typical High $10,000.00 | Facility | None | $1,202.26 | $6,309.57 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $3,801.89 | Professional | None | $1,071.52 | $1,288.25 | $3,801.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $2,089.30 Typical High $12,022.64 | Facility | None | $1,047.13 | $2,089.30 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $1,819.70 Typical High $3,090.30 | Professional | None | $1,148.15 | $1,819.70 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $891.25 Median $1,230.27 Typical High $1,995.26 | Professional | 62 · Two surgeons | $891.25 | $1,230.27 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $338.84 Typical High $512.86 | Professional | 80 · Assistant surgeon | $218.78 | $338.84 | $512.86 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $269.15 Typical High $446.68 | Professional | AS · PA/NP assist | $190.55 | $269.15 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,715.35 Typical High $4,677.35 | Facility | None | $602.56 | $3,715.35 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $2,137.96 Typical High $3,630.78 | Professional | None | $1,348.96 | $2,137.96 | $3,630.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,174.90 Median $1,479.11 Typical High $4,786.30 | Professional | None | $1,174.90 | $1,479.11 | $4,786.30 |
Oscar Health Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | None | $2,089.30 | $2,089.30 | $2,089.30 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $2,884.03 Typical High $8,709.64 | Facility | None | $1,258.93 | $2,884.03 | $8,709.64 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $1,949.84 Typical High $3,090.30 | Professional | None | $1,348.96 | $1,949.84 | $3,090.30 |
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 $537.03 Median $537.03 Typical High $724.44 | Professional | 52 · Reduced service | $537.03 | $537.03 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $213.80 Typical High $295.12 | Professional | 53 · Discontinued | $213.80 | $213.80 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $1,096.48 | Professional | 54 · Surgery only | $812.83 | $812.83 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $218.78 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $107.15 Typical High $144.54 | Professional | 56 · Pre-op care only | $107.15 | $107.15 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $1,023.29 |
Where Georgia sits
The same service costs 6.9 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· 25th of 51
$1,950
AK $5,370TX $776
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.