How much rates vary
Facilitymedian $1,549 · 10th to 90th $513 to $11,482Professionalmedian $2,630 · 10th to 90th $1,738 to $4,571
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 $1,905.46 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,905.46 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $2,187.76 | Professional | None | $1,905.46 | $1,905.46 | $2,187.76 |
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 $1,737.80 Median $2,630.27 Typical High $4,265.80 | Professional | None | $1,737.80 | $2,630.27 | $4,265.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,202.26 Median $1,659.59 Typical High $2,754.23 | Professional | 62 · Two surgeons | $1,202.26 | $1,659.59 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $302.00 Median $457.09 Typical High $741.31 | Professional | 80 · Assistant surgeon | $302.00 | $457.09 | $741.31 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $263.03 Median $371.54 Typical High $616.60 | Professional | AS · PA/NP assist | $263.03 | $371.54 | $616.60 |
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 $2,089.30 Median $3,019.95 Typical High $5,370.32 | Professional | None | $2,089.30 | $3,019.95 | $5,370.32 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,137.96 Median $2,511.89 Typical High $3,801.89 | Professional | None | $2,137.96 | $2,511.89 | $3,801.89 |
Oscar Health Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $3,467.37 | Professional | None | $3,467.37 | $3,467.37 | $3,467.37 |
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 $1,548.82 Median $2,691.53 Typical High $5,248.07 | Professional | None | $1,548.82 | $2,691.53 | $5,248.07 |
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 $954.99 Median $954.99 Typical High $1,096.48 | Professional | 52 · Reduced service | $954.99 | $954.99 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $380.19 Typical High $436.52 | Professional | 53 · Discontinued | $380.19 | $380.19 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,412.54 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,412.54 | $1,412.54 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $281.84 Typical High $331.13 | Professional | 55 · Aftercare only | $281.84 | $281.84 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $190.55 Typical High $218.78 | Professional | 56 · Pre-op care only | $190.55 | $190.55 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,318.26 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,318.26 | $1,548.82 |
Where Georgia sits
The same service costs 22.9 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· 17th of 51
$2,630
AK $7,586TX $331
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.