How much rates vary
Facilitymedian $1,820 · 10th to 90th $550 to $8,318Professionalmedian $1,000 · 10th to 90th $589 to $1,698
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 $776.25 Median $5,370.32 Typical High $10,000.00 | Facility | None | $776.25 | $5,370.32 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $691.83 Typical High $1,122.02 | Professional | None | $588.84 | $691.83 | $1,122.02 |
Ambetter Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | None | $724.44 | $724.44 | $724.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $707.95 Median $2,290.87 Typical High $10,715.19 | Facility | None | $707.95 | $2,290.87 | $10,715.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $630.96 Median $1,000.00 Typical High $1,698.24 | Professional | None | $630.96 | $1,000.00 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,096.48 Median $1,513.56 Typical High $2,570.40 | Professional | 50 · Both sides | $1,096.48 | $1,513.56 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $457.09 Median $630.96 Typical High $1,096.48 | Professional | 62 · Two surgeons | $457.09 | $630.96 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $181.97 Typical High $275.42 | Professional | 80 · Assistant surgeon | $117.49 | $181.97 | $275.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $141.25 Typical High $239.88 | Professional | AS · PA/NP assist | $102.33 | $141.25 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $549.54 Typical High $2,398.83 | Facility | None | $457.09 | $549.54 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $1,148.15 Typical High $1,995.26 | Professional | None | $724.44 | $1,148.15 | $1,995.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $645.65 Median $812.83 Typical High $1,445.44 | Professional | None | $645.65 | $812.83 | $1,445.44 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $7,585.78 | Facility | None | $954.99 | $1,995.26 | $7,585.78 |
United Setting Professional Modifier None Typical Low $707.95 Median $1,000.00 Typical High $1,659.59 | Professional | None | $707.95 | $1,000.00 | $1,659.59 |
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 $295.12 Median $295.12 Typical High $398.11 | Professional | 52 · Reduced service | $295.12 | $295.12 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $117.49 Typical High $158.49 | Professional | 53 · Discontinued | $117.49 | $117.49 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $436.52 Typical High $588.84 | Professional | 54 · Surgery only | $436.52 | $436.52 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $87.10 Typical High $117.49 | Professional | 55 · Aftercare only | $87.10 | $87.10 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $58.88 Typical High $79.43 | Professional | 56 · Pre-op care only | $58.88 | $58.88 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $407.38 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $407.38 | $407.38 | $549.54 |
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· 24th of 51
$1,047
AK $2,884TX $417
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.