How much rates vary
Facilitymedian $1,820 · 10th to 90th $646 to $6,607Professionalmedian $1,230 · 10th to 90th $794 to $1,950
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 $977.24 Median $5,370.32 Typical High $7,943.28 | Facility | None | $977.24 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $912.01 Typical High $1,318.26 | Professional | None | $870.96 | $912.01 | $1,318.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $1,148.15 Typical High $5,754.40 | Facility | None | $575.44 | $1,148.15 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $776.25 Median $1,230.27 Typical High $1,949.84 | Professional | None | $776.25 | $1,230.27 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $549.54 Median $794.33 Typical High $1,258.93 | Professional | 62 · Two surgeons | $549.54 | $794.33 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $138.04 Median $213.80 Typical High $331.13 | Professional | 80 · Assistant surgeon | $138.04 | $213.80 | $331.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $169.82 Typical High $288.40 | Professional | AS · PA/NP assist | $123.03 | $169.82 | $288.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $933.25 Median $1,023.29 Typical High $1,698.24 | Professional | None | $933.25 | $1,023.29 | $1,698.24 |
Oscar Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,513.56 Typical High $1,584.89 | Professional | None | $1,348.96 | $1,513.56 | $1,584.89 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $7,585.78 | Facility | None | $954.99 | $1,995.26 | $7,585.78 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,318.26 Typical High $2,187.76 | Professional | None | $776.25 | $1,318.26 | $2,187.76 |
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 $436.52 Median $457.09 Typical High $501.19 | Professional | 52 · Reduced service | $436.52 | $457.09 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $181.97 Typical High $199.53 | Professional | 53 · Discontinued | $173.78 | $181.97 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $691.83 Typical High $741.31 | Professional | 54 · Surgery only | $660.69 | $691.83 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $138.04 Typical High $147.91 | Professional | 55 · Aftercare only | $131.83 | $138.04 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $91.20 Typical High $100.00 | Professional | 56 · Pre-op care only | $87.10 | $91.20 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $645.65 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $616.60 | $645.65 | $691.83 |
Where Georgia sits
The same service costs 3.4 times more in Wisconsin than in Kansas. 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 $8,857KS $2,587
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.