How much rates vary
Facilitymedian $2,884 · 10th to 90th $646 to $7,079Professionalmedian $1,230 · 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 $891.25 Median $5,370.32 Typical High $10,000.00 | Facility | None | $891.25 | $5,370.32 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,096.48 | Professional | None | $891.25 | $891.25 | $1,096.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $1,148.15 Typical High $5,754.40 | Facility | None | $575.44 | $1,148.15 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $794.33 Median $1,230.27 Typical High $2,041.74 | Professional | None | $794.33 | $1,230.27 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $562.34 Median $794.33 Typical High $1,288.25 | Professional | 62 · Two surgeons | $562.34 | $794.33 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $208.93 Typical High $346.74 | Professional | 80 · Assistant surgeon | $141.25 | $208.93 | $346.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $173.78 Typical High $288.40 | Professional | AS · PA/NP assist | $123.03 | $173.78 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $4,265.80 Typical High $5,888.44 | Facility | None | $1,348.96 | $4,265.80 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,380.38 Typical High $2,344.23 | Professional | None | $1,000.00 | $1,380.38 | $2,344.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $977.24 Median $1,096.48 Typical High $1,584.89 | Professional | None | $977.24 | $1,096.48 | $1,584.89 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $3,715.35 Typical High $10,000.00 | Facility | None | $1,513.56 | $3,715.35 | $10,000.00 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,230.27 Typical High $2,290.87 | Professional | None | $758.58 | $1,230.27 | $2,290.87 |
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 $446.68 Median $446.68 Typical High $501.19 | Professional | 52 · Reduced service | $446.68 | $446.68 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $199.53 | Professional | 53 · Discontinued | $177.83 | $177.83 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $741.31 | Professional | 54 · Surgery only | $660.69 | $660.69 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $134.90 Typical High $147.91 | Professional | 55 · Aftercare only | $131.83 | $134.90 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $100.00 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $691.83 |
Where Georgia sits
The same service costs 5.1 times more in Oklahoma 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
OK $11,738KY $2,311
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.