How much rates vary
Facilitymedian $1,148 · 10th to 90th $562 to $5,370Professionalmedian $1,585 · 10th to 90th $1,047 to $2,692
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 $1,148.15 Median $1,148.15 Typical High $1,412.54 | Professional | None | $1,148.15 | $1,148.15 | $1,412.54 |
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 $977.24 Median $1,584.89 Typical High $2,570.40 | Professional | None | $977.24 | $1,584.89 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,698.24 Median $2,454.71 Typical High $4,073.80 | Professional | 50 · Both sides | $1,698.24 | $2,454.71 | $4,073.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $707.95 Median $1,023.29 Typical High $1,698.24 | Professional | 62 · Two surgeons | $707.95 | $1,023.29 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $275.42 Typical High $436.52 | Professional | 80 · Assistant surgeon | $181.97 | $275.42 | $436.52 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $229.09 Typical High $380.19 | Professional | AS · PA/NP assist | $158.49 | $229.09 | $380.19 |
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 $1,318.26 Median $1,862.09 Typical High $2,951.21 | Professional | None | $1,318.26 | $1,862.09 | $2,951.21 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,202.26 Median $1,348.96 Typical High $4,365.16 | Professional | None | $1,202.26 | $1,348.96 | $4,365.16 |
Oscar Health Setting Professional Modifier None Typical Low $1,737.80 Median $1,949.84 Typical High $2,041.74 | Professional | None | $1,737.80 | $1,949.84 | $2,041.74 |
United Setting Facility Modifier None Typical Low $501.19 Median $724.44 Typical High $3,548.13 | Facility | None | $501.19 | $724.44 | $3,548.13 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,698.24 Typical High $2,884.03 | Professional | None | $1,023.29 | $1,698.24 | $2,884.03 |
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 $575.44 Median $575.44 Typical High $660.69 | Professional | 52 · Reduced service | $575.44 | $575.44 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $263.03 | Professional | 53 · Discontinued | $234.42 | $234.42 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $870.96 Typical High $977.24 | Professional | 54 · Surgery only | $870.96 | $870.96 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $173.78 Typical High $194.98 | Professional | 55 · Aftercare only | $173.78 | $173.78 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $131.83 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $812.83 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $812.83 | $812.83 | $912.01 |
Where Georgia sits
The same service costs 3.7 times more in Alabama than in Delaware. 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
AL $8,194DE $2,218
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.