How much rates vary
Facilitymedian $2,692 · 10th to 90th $631 to $8,710Professionalmedian $1,479 · 10th to 90th $977 to $2,512
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 $1,096.48 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,096.48 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,096.48 Typical High $1,318.26 | Professional | None | $1,071.52 | $1,096.48 | $1,318.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,548.82 Typical High $10,964.78 | Facility | None | $588.84 | $1,548.82 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,479.11 Typical High $2,398.83 | Professional | None | $933.25 | $1,479.11 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,584.89 Median $2,238.72 Typical High $3,630.78 | Professional | 50 · Both sides | $1,584.89 | $2,238.72 | $3,630.78 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $676.08 Median $933.25 Typical High $1,513.56 | Professional | 62 · Two surgeons | $676.08 | $933.25 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $245.47 Typical High $407.38 | Professional | 80 · Assistant surgeon | $165.96 | $245.47 | $407.38 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $208.93 Typical High $338.84 | Professional | AS · PA/NP assist | $147.91 | $208.93 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,073.80 Typical High $5,128.61 | Facility | None | $602.56 | $4,073.80 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,584.89 Typical High $2,818.38 | Professional | None | $1,148.15 | $1,584.89 | $2,818.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $2,511.89 | Professional | None | $1,122.02 | $1,258.93 | $2,511.89 |
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 $933.25 Median $1,513.56 Typical High $2,691.53 | Professional | None | $933.25 | $1,513.56 | $2,691.53 |
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 $537.03 Median $549.54 Typical High $602.56 | Professional | 52 · Reduced service | $537.03 | $549.54 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $218.78 Typical High $239.88 | Professional | 53 · Discontinued | $213.80 | $218.78 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $812.83 Typical High $912.01 | Professional | 54 · Surgery only | $794.33 | $812.83 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $162.18 Typical High $181.97 | Professional | 55 · Aftercare only | $158.49 | $162.18 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $109.65 Typical High $120.23 | Professional | 56 · Pre-op care only | $107.15 | $109.65 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $758.58 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $741.31 | $758.58 | $851.14 |
Where Georgia sits
The same service costs 5.1 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 $14,362HI $2,794
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.