How much rates vary
Facilitymedian $2,754 · 10th to 90th $1,000 to $7,586Professionalmedian $1,122 · 10th to 90th $708 to $1,862
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 $812.83 Median $7,079.46 Typical High $12,302.69 | Facility | None | $812.83 | $7,079.46 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,659.59 | Professional | None | $812.83 | $812.83 | $1,659.59 |
Ambetter Setting Professional Modifier None Typical Low $724.44 Median $1,318.26 Typical High $1,318.26 | Professional | None | $724.44 | $1,318.26 | $1,318.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $1,698.24 Typical High $7,244.36 | Facility | None | $954.99 | $1,698.24 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $691.83 Median $1,122.02 Typical High $1,778.28 | Professional | None | $691.83 | $1,122.02 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,202.26 Median $1,698.24 Typical High $2,691.53 | Professional | 50 · Both sides | $1,202.26 | $1,698.24 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $501.19 Median $707.95 Typical High $1,230.27 | Professional | 62 · Two surgeons | $501.19 | $707.95 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $190.55 Typical High $302.00 | Professional | 80 · Assistant surgeon | $125.89 | $190.55 | $302.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $154.88 Typical High $263.03 | Professional | AS · PA/NP assist | $112.20 | $154.88 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $1,122.02 Median $3,467.37 Typical High $4,677.35 | Facility | None | $1,122.02 | $3,467.37 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,258.93 Typical High $2,089.30 | Professional | None | $912.01 | $1,258.93 | $2,089.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $794.33 Median $891.25 Typical High $1,621.81 | Professional | None | $794.33 | $891.25 | $1,621.81 |
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 $724.44 Median $1,148.15 Typical High $2,041.74 | Professional | None | $724.44 | $1,148.15 | $2,041.74 |
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 $407.38 Median $407.38 Typical High $457.09 | Professional | 52 · Reduced service | $407.38 | $407.38 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $165.96 Typical High $181.97 | Professional | 53 · Discontinued | $162.18 | $165.96 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $616.60 Typical High $691.83 | Professional | 54 · Surgery only | $602.56 | $616.60 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $123.03 Typical High $138.04 | Professional | 55 · Aftercare only | $120.23 | $123.03 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $91.20 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $575.44 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $562.34 | $575.44 | $645.65 |
Where Georgia sits
The same service costs 4.9 times more in Alaska than in Kentucky. 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.
Physician feeFacility fee
AK $10,315KY $2,095
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.