How much rates vary
Facilitymedian $5,370 · 10th to 90th $1,259 to $16,218Professionalmedian $2,512 · 10th to 90th $1,585 to $4,169
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 $1,819.70 Median $7,244.36 Typical High $12,302.69 | Facility | None | $1,819.70 | $7,244.36 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $2,041.74 | Professional | None | $1,819.70 | $1,819.70 | $2,041.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $2,344.23 Typical High $16,218.10 | Facility | None | $1,288.25 | $2,344.23 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,548.82 Median $2,511.89 Typical High $3,981.07 | Professional | None | $1,548.82 | $2,511.89 | $3,981.07 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,691.53 Median $3,890.45 Typical High $6,025.60 | Professional | 50 · Both sides | $2,691.53 | $3,890.45 | $6,025.60 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $281.84 Median $436.52 Typical High $676.08 | Professional | 80 · Assistant surgeon | $281.84 | $436.52 | $676.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $251.19 Median $363.08 Typical High $588.84 | Professional | AS · PA/NP assist | $251.19 | $363.08 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $13,803.84 Typical High $18,197.01 | Facility | None | $602.56 | $13,803.84 | $18,197.01 |
Cigna Setting Professional Modifier None Typical Low $2,041.74 Median $3,019.95 Typical High $4,677.35 | Professional | None | $2,041.74 | $3,019.95 | $4,677.35 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,778.28 Median $1,995.26 Typical High $10,000.00 | Professional | None | $1,778.28 | $1,995.26 | $10,000.00 |
Oscar Health Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,162.28 | Professional | None | $3,019.95 | $3,019.95 | $3,162.28 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $6,760.83 Typical High $13,182.57 | Facility | None | $1,513.56 | $6,760.83 | $13,182.57 |
United Setting Professional Modifier None Typical Low $1,659.59 Median $2,884.03 Typical High $4,570.88 | Professional | None | $1,659.59 | $2,884.03 | $4,570.88 |
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 $912.01 Median $912.01 Typical High $1,023.29 | Professional | 52 · Reduced service | $912.01 | $912.01 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $363.08 Typical High $407.38 | Professional | 53 · Discontinued | $363.08 | $363.08 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,348.96 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,348.96 | $1,348.96 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $275.42 Typical High $309.03 | Professional | 55 · Aftercare only | $275.42 | $275.42 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $181.97 Typical High $204.17 | Professional | 56 · Pre-op care only | $181.97 | $181.97 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,258.93 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,258.93 | $1,445.44 |
Where Georgia sits
The same service costs 7.8 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 $31,233KY $3,989
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.