How much rates vary
Facilitymedian $2,884 · 10th to 90th $851 to $8,710Professionalmedian $1,778 · 10th to 90th $1,148 to $3,090
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 $1,318.26 Median $5,495.41 Typical High $9,549.93 | Facility | None | $1,318.26 | $5,495.41 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $3,548.13 | Professional | None | $1,318.26 | $1,318.26 | $3,548.13 |
Ambetter Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $812.83 Median $1,698.24 Typical High $10,964.78 | Facility | None | $812.83 | $1,698.24 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $1,778.28 Typical High $2,884.03 | Professional | None | $1,096.48 | $1,778.28 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $812.83 Median $1,174.90 Typical High $1,905.46 | Professional | 62 · Two surgeons | $812.83 | $1,174.90 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $309.03 Typical High $489.78 | Professional | 80 · Assistant surgeon | $204.17 | $309.03 | $489.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $257.04 Typical High $426.58 | Professional | AS · PA/NP assist | $177.83 | $257.04 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $4,073.80 Typical High $5,370.32 | Facility | None | $812.83 | $4,073.80 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $2,089.30 Typical High $3,388.44 | Professional | None | $1,479.11 | $2,089.30 | $3,388.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,318.26 Median $1,513.56 Typical High $2,951.21 | Professional | None | $1,318.26 | $1,513.56 | $2,951.21 |
Oscar Health Setting Professional Modifier None Typical Low $1,258.93 Median $2,238.72 Typical High $2,818.38 | Professional | None | $1,258.93 | $2,238.72 | $2,818.38 |
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 $1,174.90 Median $1,905.46 Typical High $3,311.31 | Professional | None | $1,174.90 | $1,905.46 | $3,311.31 |
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 $660.69 Median $660.69 Typical High $741.31 | Professional | 52 · Reduced service | $660.69 | $660.69 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $295.12 | Professional | 53 · Discontinued | $263.03 | $263.03 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,000.00 Typical High $1,096.48 | Professional | 54 · Surgery only | $977.24 | $1,000.00 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $199.53 Typical High $223.87 | Professional | 55 · Aftercare only | $194.98 | $199.53 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $147.91 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $933.25 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $912.01 | $933.25 | $1,023.29 |
Where Georgia sits
The same service costs 4.0 times more in Colorado than in Hawaii. 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
CO $14,661HI $3,664
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.