How much rates vary
Facilitymedian $1,622 · 10th to 90th $525 to $11,482Professionalmedian $2,455 · 10th to 90th $1,514 to $4,266
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 $1,737.80 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,737.80 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $2,041.74 | Professional | None | $1,737.80 | $1,737.80 | $2,041.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,122.02 Median $3,162.28 Typical High $16,218.10 | Facility | None | $1,122.02 | $3,162.28 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,445.44 Median $2,454.71 Typical High $3,890.45 | Professional | None | $1,445.44 | $2,454.71 | $3,890.45 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,096.48 Median $1,548.82 Typical High $2,570.40 | Professional | 62 · Two surgeons | $1,096.48 | $1,548.82 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $275.42 Median $426.58 Typical High $676.08 | Professional | 80 · Assistant surgeon | $275.42 | $426.58 | $676.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $245.47 Median $346.74 Typical High $575.44 | Professional | AS · PA/NP assist | $245.47 | $346.74 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $549.54 Typical High $2,570.40 | Facility | None | $501.19 | $549.54 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $2,754.23 Typical High $4,897.79 | Professional | None | $1,862.09 | $2,754.23 | $4,897.79 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,949.84 Median $2,290.87 Typical High $3,890.45 | Professional | None | $1,949.84 | $2,290.87 | $3,890.45 |
Oscar Health Setting Professional Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,235.94 | Professional | None | $3,235.94 | $3,235.94 | $3,235.94 |
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 $1,445.44 Median $2,344.23 Typical High $4,786.30 | Professional | None | $1,445.44 | $2,344.23 | $4,786.30 |
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 $870.96 Median $870.96 Typical High $1,023.29 | Professional | 52 · Reduced service | $870.96 | $870.96 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $346.74 Typical High $407.38 | Professional | 53 · Discontinued | $346.74 | $346.74 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,318.26 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,318.26 | $1,318.26 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $263.03 Typical High $309.03 | Professional | 55 · Aftercare only | $263.03 | $263.03 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $173.78 Typical High $204.17 | Professional | 56 · Pre-op care only | $173.78 | $173.78 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,230.27 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,230.27 | $1,412.54 |
Where Georgia sits
The same service costs 6.0 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· 16th of 51
$2,455
AK $7,079TX $1,175
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.