How much rates vary
Facilitymedian $1,047 · 10th to 90th $126 to $4,467Professionalmedian $1,288 · 10th to 90th $813 to $2,138
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 $1,148.15 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,148.15 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,174.90 Typical High $1,412.54 | Professional | None | $1,096.48 | $1,174.90 | $1,412.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $562.34 Median $1,071.52 Typical High $4,570.88 | Facility | None | $562.34 | $1,071.52 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $794.33 Median $1,348.96 Typical High $1,862.09 | Professional | None | $794.33 | $1,348.96 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,412.54 Median $1,995.26 Typical High $2,754.23 | Professional | 50 · Both sides | $1,412.54 | $1,995.26 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $208.93 Typical High $295.12 | Professional | 80 · Assistant surgeon | $147.91 | $208.93 | $295.12 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $186.21 Typical High $257.04 | Professional | AS · PA/NP assist | $131.83 | $186.21 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,445.44 Typical High $1,995.26 | Facility | None | $602.56 | $1,445.44 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,479.11 Typical High $2,570.40 | Professional | None | $977.24 | $1,479.11 | $2,570.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $977.24 Median $1,122.02 Typical High $1,737.80 | Professional | None | $977.24 | $1,122.02 | $1,737.80 |
Oscar Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,412.54 Typical High $1,479.11 | Professional | None | $1,230.27 | $1,412.54 | $1,479.11 |
United Setting Facility Modifier None Typical Low $79.43 Median $158.49 Typical High $1,778.28 | Facility | None | $79.43 | $158.49 | $1,778.28 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,348.96 Typical High $2,630.27 | Professional | None | $891.25 | $1,348.96 | $2,630.27 |
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 $549.54 Median $562.34 Typical High $616.60 | Professional | 52 · Reduced service | $549.54 | $562.34 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $229.09 Typical High $251.19 | Professional | 53 · Discontinued | $218.78 | $229.09 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $851.14 Typical High $933.25 | Professional | 54 · Surgery only | $831.76 | $851.14 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $169.82 Typical High $186.21 | Professional | 55 · Aftercare only | $165.96 | $169.82 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $114.82 Typical High $125.89 | Professional | 56 · Pre-op care only | $109.65 | $114.82 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $794.33 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $776.25 | $794.33 | $870.96 |
Where Georgia sits
The same service costs 7.2 times more in Alaska than in Utah. 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· 19th of 51
$1,288
AK $3,890UT $537
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.