How much rates vary
Facilitymedian $2,692 · 10th to 90th $759 to $8,913Professionalmedian $759 · 10th to 90th $603 to $1,288
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 $616.60 Median $758.58 Typical High $8,511.38 | Facility | None | $616.60 | $758.58 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $691.83 Typical High $1,071.52 | Professional | None | $616.60 | $691.83 | $1,071.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $3,311.31 Typical High $9,120.11 | Facility | None | $1,047.13 | $3,311.31 | $9,120.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $588.84 Median $758.58 Typical High $1,288.25 | Professional | None | $588.84 | $758.58 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $371.54 Median $478.63 Typical High $812.83 | Professional | 62 · Two surgeons | $371.54 | $478.63 | $812.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $123.03 Typical High $208.93 | Professional | 80 · Assistant surgeon | $93.33 | $123.03 | $208.93 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $81.28 Median $107.15 Typical High $181.97 | Professional | AS · PA/NP assist | $81.28 | $107.15 | $181.97 |
CareSource Setting Facility Modifier None Typical Low $645.65 Median $1,071.52 Typical High $2,691.53 | Facility | None | $645.65 | $1,071.52 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $660.69 Median $870.96 Typical High $1,096.48 | Professional | None | $660.69 | $870.96 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,122.02 Typical High $1,348.96 | Professional | None | $794.33 | $1,122.02 | $1,348.96 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $389.05 | Professional | None | $33.11 | $33.11 | $389.05 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,089.30 Typical High $6,760.83 | Facility | None | $831.76 | $2,089.30 | $6,760.83 |
United Setting Professional Modifier None Typical Low $724.44 Median $870.96 Typical High $1,288.25 | Professional | None | $724.44 | $870.96 | $1,288.25 |
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 $309.03 Median $346.74 Typical High $457.09 | Professional | 52 · Reduced service | $309.03 | $346.74 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $141.25 Typical High $181.97 | Professional | 53 · Discontinued | $123.03 | $141.25 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $524.81 Typical High $676.08 | Professional | 54 · Surgery only | $457.09 | $524.81 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $104.71 Typical High $134.90 | Professional | 55 · Aftercare only | $91.20 | $104.71 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $69.18 Typical High $91.20 | Professional | 56 · Pre-op care only | $61.66 | $69.18 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $489.78 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $426.58 | $489.78 | $630.96 |
Where Kentucky sits
The same service costs 4.4 times more in Wisconsin than in Montana. 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
WI $9,724MT $2,195
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.