How much rates vary
Facilitymedian $3,802 · 10th to 90th $1,148 to $11,482Professionalmedian $1,585 · 10th to 90th $977 to $2,754
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 $1,230.27 Median $9,332.54 Typical High $15,488.17 | Facility | None | $1,230.27 | $9,332.54 | $15,488.17 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $1,202.26 Typical High $3,090.30 | Professional | None | $912.01 | $1,202.26 | $3,090.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,258.93 Median $2,238.72 Typical High $11,748.98 | Facility | None | $1,258.93 | $2,238.72 | $11,748.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,584.89 Typical High $2,691.53 | Professional | None | $977.24 | $1,584.89 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $1,071.52 Typical High $1,698.24 | Professional | 62 · Two surgeons | $758.58 | $1,071.52 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $288.40 Typical High $436.52 | Professional | 80 · Assistant surgeon | $186.21 | $288.40 | $436.52 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $239.88 Typical High $380.19 | Professional | AS · PA/NP assist | $165.96 | $239.88 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $5,888.44 Typical High $7,762.47 | Facility | None | $831.76 | $5,888.44 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,862.09 Typical High $3,090.30 | Professional | None | $1,148.15 | $1,862.09 | $3,090.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,023.29 Median $1,288.25 Typical High $3,467.37 | Professional | None | $1,023.29 | $1,288.25 | $3,467.37 |
Oscar Health Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,778.28 | $1,778.28 | $1,778.28 |
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 $1,174.90 Median $1,698.24 Typical High $2,630.27 | Professional | None | $1,174.90 | $1,698.24 | $2,630.27 |
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 $616.60 | Professional | 52 · Reduced service | $457.09 | $457.09 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $251.19 | Professional | 53 · Discontinued | $181.97 | $181.97 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $933.25 | Professional | 54 · Surgery only | $691.83 | $691.83 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $186.21 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $125.89 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $645.65 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $645.65 | $645.65 | $870.96 |
Where Georgia sits
The same service costs 8.7 times more in Oklahoma 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· 19th of 51
$1,820
OK $6,166TX $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.