How much rates vary
Facilitymedian $2,291 · 10th to 90th $832 to $8,511Professionalmedian $871 · 10th to 90th $692 to $1,413
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 $758.58 Median $933.25 Typical High $8,511.38 | Facility | None | $758.58 | $933.25 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $870.96 Typical High $1,288.25 | Professional | None | $758.58 | $870.96 | $1,288.25 |
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 $691.83 Median $831.76 Typical High $1,348.96 | Professional | None | $691.83 | $831.76 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $134.90 Typical High $213.80 | Professional | 80 · Assistant surgeon | $112.20 | $134.90 | $213.80 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $97.72 Median $117.49 Typical High $190.55 | Professional | AS · PA/NP assist | $97.72 | $117.49 | $190.55 |
CareSource Setting Facility Modifier None Typical Low $812.83 Median $1,318.26 Typical High $2,691.53 | Facility | None | $812.83 | $1,318.26 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $912.01 Median $1,122.02 Typical High $1,348.96 | Professional | None | $912.01 | $1,122.02 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $1,479.11 Median $1,905.46 Typical High $2,290.87 | Facility | None | $1,479.11 | $1,905.46 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,047.13 Typical High $6,918.31 | Professional | None | $831.76 | $1,047.13 | $6,918.31 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $346.74 | Professional | None | $33.11 | $33.11 | $346.74 |
United Setting Facility Modifier None Typical Low $741.31 Median $1,479.11 Typical High $5,128.61 | Facility | None | $741.31 | $1,479.11 | $5,128.61 |
United Setting Professional Modifier None Typical Low $794.33 Median $977.24 Typical High $1,513.56 | Professional | None | $794.33 | $977.24 | $1,513.56 |
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 $380.19 Median $436.52 Typical High $562.34 | Professional | 52 · Reduced service | $380.19 | $436.52 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $173.78 Typical High $223.87 | Professional | 53 · Discontinued | $151.36 | $173.78 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $645.65 Typical High $851.14 | Professional | 54 · Surgery only | $562.34 | $645.65 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $128.82 Typical High $169.82 | Professional | 55 · Aftercare only | $112.20 | $128.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $87.10 Typical High $112.20 | Professional | 56 · Pre-op care only | $75.86 | $87.10 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $602.56 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $524.81 | $602.56 | $794.33 |
Where Kentucky sits
The same service costs 3.0 times more in Wisconsin than in Maryland. 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 $7,993MD $2,690
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.