How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,047 to $10,000Professionalmedian $3,467 · 10th to 90th $2,399 to $5,888
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 $2,511.89 Median $6,309.57 Typical High $10,000.00 | Facility | None | $2,511.89 | $6,309.57 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,818.38 | Professional | None | $2,511.89 | $2,511.89 | $2,818.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,071.52 Median $1,905.46 Typical High $11,220.18 | Facility | None | $1,071.52 | $1,905.46 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,398.83 Median $3,467.37 Typical High $5,623.41 | Professional | None | $2,398.83 | $3,467.37 | $5,623.41 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,548.82 Median $2,187.76 Typical High $3,548.13 | Professional | 62 · Two surgeons | $1,548.82 | $2,187.76 | $3,548.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $398.11 Median $588.84 Typical High $954.99 | Professional | 80 · Assistant surgeon | $398.11 | $588.84 | $954.99 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $346.74 Median $489.78 Typical High $794.33 | Professional | AS · PA/NP assist | $346.74 | $489.78 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,168.69 Typical High $5,370.32 | Facility | None | $602.56 | $4,168.69 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $2,884.03 Median $3,981.07 Typical High $6,456.54 | Professional | None | $2,884.03 | $3,981.07 | $6,456.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,630.27 Median $2,951.21 Typical High $15,848.93 | Professional | None | $2,630.27 | $2,951.21 | $15,848.93 |
Oscar Health Setting Professional Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $4,466.84 | Professional | None | $4,466.84 | $4,466.84 | $4,466.84 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $3,715.35 Typical High $9,549.93 | Facility | None | $1,513.56 | $3,715.35 | $9,549.93 |
United Setting Professional Modifier None Typical Low $2,187.76 Median $3,548.13 Typical High $6,309.57 | Professional | None | $2,187.76 | $3,548.13 | $6,309.57 |
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 $1,258.93 Median $1,258.93 Typical High $1,412.54 | Professional | 52 · Reduced service | $1,258.93 | $1,258.93 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $501.19 Median $501.19 Typical High $562.34 | Professional | 53 · Discontinued | $501.19 | $501.19 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,862.09 Median $1,862.09 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,862.09 | $1,862.09 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $371.54 Median $371.54 Typical High $426.58 | Professional | 55 · Aftercare only | $371.54 | $371.54 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $251.19 Median $251.19 Typical High $281.84 | Professional | 56 · Pre-op care only | $251.19 | $251.19 | $281.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,737.80 Median $1,737.80 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,737.80 | $1,737.80 | $1,995.26 |
Where Georgia sits
The same service costs 4.0 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.
Physician feeFacility fee
AK $19,772TX $4,915
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.