How much rates vary
Facilitymedian $1,148 · 10th to 90th $513 to $8,128Professionalmedian $1,738 · 10th to 90th $1,096 to $2,951
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 $1,288.25 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,288.25 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,479.11 | Professional | None | $1,288.25 | $1,288.25 | $1,479.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $707.95 Median $2,290.87 Typical High $13,489.63 | Facility | None | $707.95 | $2,290.87 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,047.13 Median $1,737.80 Typical High $2,754.23 | Professional | None | $1,047.13 | $1,737.80 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $776.25 Median $1,122.02 Typical High $1,819.70 | Professional | 62 · Two surgeons | $776.25 | $1,122.02 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $295.12 Typical High $489.78 | Professional | 80 · Assistant surgeon | $194.98 | $295.12 | $489.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $245.47 Typical High $398.11 | Professional | AS · PA/NP assist | $173.78 | $245.47 | $398.11 |
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 $1,479.11 Median $2,041.74 Typical High $3,467.37 | Professional | None | $1,479.11 | $2,041.74 | $3,467.37 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,258.93 Median $1,548.82 Typical High $2,951.21 | Professional | None | $1,258.93 | $1,548.82 | $2,951.21 |
Oscar Health Setting Professional Modifier None Typical Low $2,137.96 Median $2,238.72 Typical High $2,238.72 | Professional | None | $2,137.96 | $2,238.72 | $2,238.72 |
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 $1,096.48 Median $1,905.46 Typical High $3,467.37 | Professional | None | $1,096.48 | $1,905.46 | $3,467.37 |
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 $645.65 Median $645.65 Typical High $741.31 | Professional | 52 · Reduced service | $645.65 | $645.65 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $263.03 Typical High $302.00 | Professional | 53 · Discontinued | $257.04 | $263.03 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $977.24 Typical High $1,122.02 | Professional | 54 · Surgery only | $977.24 | $977.24 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $223.87 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $147.91 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $1,047.13 |
Where Georgia sits
The same service costs 6.5 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
$1,738
AK $5,012TX $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.