How much rates vary
Facilitymedian $2,570 · 10th to 90th $631 to $7,413Professionalmedian $1,905 · 10th to 90th $1,230 to $3,388
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 $1,412.54 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,412.54 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,949.84 | Professional | None | $1,412.54 | $1,412.54 | $1,949.84 |
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 $1,148.15 Median $1,905.46 Typical High $3,388.44 | Professional | None | $1,148.15 | $1,905.46 | $3,388.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $851.14 Median $1,258.93 Typical High $2,137.96 | Professional | 62 · Two surgeons | $851.14 | $1,258.93 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $346.74 Typical High $562.34 | Professional | 80 · Assistant surgeon | $218.78 | $346.74 | $562.34 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $281.84 Typical High $478.63 | Professional | AS · PA/NP assist | $190.55 | $281.84 | $478.63 |
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 $1,584.89 Median $2,238.72 Typical High $3,981.07 | Professional | None | $1,584.89 | $2,238.72 | $3,981.07 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,412.54 Median $1,698.24 Typical High $3,090.30 | Professional | None | $1,412.54 | $1,698.24 | $3,090.30 |
Oscar Health Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Professional | None | $2,511.89 | $2,511.89 | $2,511.89 |
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 $1,202.26 Median $2,041.74 Typical High $3,715.35 | Professional | None | $1,202.26 | $2,041.74 | $3,715.35 |
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 $707.95 Median $707.95 Typical High $812.83 | Professional | 52 · Reduced service | $707.95 | $707.95 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $331.13 | Professional | 53 · Discontinued | $281.84 | $281.84 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,047.13 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,047.13 | $1,047.13 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $245.47 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $162.18 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $977.24 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $977.24 | $977.24 | $1,148.15 |
Where Georgia sits
The same service costs 7.2 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
$1,905
AK $5,495TX $759
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.