How much rates vary
Facilitymedian $2,570 · 10th to 90th $631 to $7,413Professionalmedian $1,995 · 10th to 90th $1,259 to $3,548
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 $1,479.11 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,479.11 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,862.09 | Professional | None | $1,479.11 | $1,479.11 | $1,862.09 |
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 $1,202.26 Median $1,995.26 Typical High $3,467.37 | Professional | None | $1,202.26 | $1,995.26 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $891.25 Median $1,318.26 Typical High $2,290.87 | Professional | 62 · Two surgeons | $891.25 | $1,318.26 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $229.09 Median $354.81 Typical High $588.84 | Professional | 80 · Assistant surgeon | $229.09 | $354.81 | $588.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $288.40 Typical High $512.86 | Professional | AS · PA/NP assist | $199.53 | $288.40 | $512.86 |
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 $1,659.59 Median $2,344.23 Typical High $4,265.80 | Professional | None | $1,659.59 | $2,344.23 | $4,265.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,445.44 Median $1,778.28 Typical High $3,235.94 | Professional | None | $1,445.44 | $1,778.28 | $3,235.94 |
Oscar Health Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Professional | None | $2,630.27 | $2,630.27 | $2,630.27 |
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 $1,258.93 Median $2,089.30 Typical High $3,890.45 | Professional | None | $1,258.93 | $2,089.30 | $3,890.45 |
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 $741.31 Median $741.31 Typical High $851.14 | Professional | 52 · Reduced service | $741.31 | $741.31 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $295.12 Typical High $338.84 | Professional | 53 · Discontinued | $295.12 | $295.12 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,096.48 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,096.48 | $1,096.48 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $218.78 Typical High $257.04 | Professional | 55 · Aftercare only | $218.78 | $218.78 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $147.91 Typical High $169.82 | Professional | 56 · Pre-op care only | $147.91 | $147.91 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,023.29 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,023.29 | $1,202.26 |
Where Georgia sits
The same service costs 24.5 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· 24th of 51
$1,995
AK $5,754TX $234
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.