How much rates vary
Facilitymedian $1,995 · 10th to 90th $794 to $6,607Professionalmedian $1,738 · 10th to 90th $1,122 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 $1,513.56 Median $5,623.41 Typical High $9,549.93 | Facility | None | $1,513.56 | $5,623.41 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,548.82 Typical High $2,238.72 | Professional | None | $1,445.44 | $1,548.82 | $2,238.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $1,412.54 Typical High $5,754.40 | Facility | None | $741.31 | $1,412.54 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,778.28 Typical High $2,511.89 | Professional | None | $1,122.02 | $1,778.28 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,778.28 Median $2,691.53 Typical High $3,801.89 | Professional | 50 · Both sides | $1,778.28 | $2,691.53 | $3,801.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $776.25 Median $1,122.02 Typical High $1,584.89 | Professional | 62 · Two surgeons | $776.25 | $1,122.02 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $281.84 Typical High $407.38 | Professional | 80 · Assistant surgeon | $190.55 | $281.84 | $407.38 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $251.19 Typical High $354.81 | Professional | AS · PA/NP assist | $165.96 | $251.19 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $2,511.89 Typical High $3,388.44 | Facility | None | $812.83 | $2,511.89 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,995.26 Typical High $3,548.13 | Professional | None | $1,258.93 | $1,995.26 | $3,548.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,380.38 Median $1,548.82 Typical High $2,884.03 | Professional | None | $1,380.38 | $1,548.82 | $2,884.03 |
Oscar Health Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,995.26 | $1,995.26 | $1,995.26 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $7,585.78 | Facility | None | $954.99 | $1,995.26 | $7,585.78 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,778.28 Typical High $3,630.78 | Professional | None | $1,174.90 | $1,778.28 | $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 $758.58 Median $776.25 Typical High $851.14 | Professional | 52 · Reduced service | $758.58 | $776.25 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $309.03 Typical High $338.84 | Professional | 53 · Discontinued | $302.00 | $309.03 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,148.15 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,122.02 | $1,148.15 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $229.09 Typical High $251.19 | Professional | 55 · Aftercare only | $223.87 | $229.09 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $154.88 Typical High $169.82 | Professional | 56 · Pre-op care only | $151.36 | $154.88 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,071.52 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,071.52 | $1,174.90 |
Where Georgia sits
The same service costs 7.1 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· 24th of 51
$1,778
AK $5,370UT $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.