How much rates vary
Facilitymedian $2,570 · 10th to 90th $631 to $7,413Professionalmedian $1,862 · 10th to 90th $1,175 to $3,236
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 $1,348.96 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,348.96 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,698.24 | Professional | None | $1,348.96 | $1,348.96 | $1,698.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,230.27 Typical High $7,244.36 | Facility | None | $588.84 | $1,230.27 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $1,862.09 Typical High $3,235.94 | Professional | None | $1,096.48 | $1,862.09 | $3,235.94 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $831.76 Median $1,202.26 Typical High $2,041.74 | Professional | 62 · Two surgeons | $831.76 | $1,202.26 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $331.13 Typical High $549.54 | Professional | 80 · Assistant surgeon | $208.93 | $331.13 | $549.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $263.03 Typical High $457.09 | Professional | AS · PA/NP assist | $186.21 | $263.03 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,570.88 Typical High $5,888.44 | Facility | None | $602.56 | $4,570.88 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $2,187.76 Typical High $3,890.45 | Professional | None | $1,513.56 | $2,187.76 | $3,890.45 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,348.96 Median $1,584.89 Typical High $2,884.03 | Professional | None | $1,348.96 | $1,584.89 | $2,884.03 |
Oscar Health Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Professional | None | $2,398.83 | $2,398.83 | $2,398.83 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $2,884.03 Typical High $8,709.64 | Facility | None | $1,258.93 | $2,884.03 | $8,709.64 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $1,949.84 Typical High $3,630.78 | Professional | None | $1,148.15 | $1,949.84 | $3,630.78 |
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 $676.08 Median $676.08 Typical High $794.33 | Professional | 52 · Reduced service | $676.08 | $676.08 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $275.42 Typical High $316.23 | Professional | 53 · Discontinued | $275.42 | $275.42 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,023.29 Typical High $1,174.90 | Professional | 54 · Surgery only | $1,023.29 | $1,023.29 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $204.17 Typical High $239.88 | Professional | 55 · Aftercare only | $204.17 | $204.17 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $158.49 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $954.99 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $954.99 | $954.99 | $1,096.48 |
Where Georgia sits
The same service costs 11.0 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· 24th of 51
$1,862
AK $5,370TX $490
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.