How much rates vary
Facilitymedian $1,148 · 10th to 90th $562 to $5,370Professionalmedian $871 · 10th to 90th $550 to $1,479
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 $616.60 Median $630.96 Typical High $954.99 | Professional | None | $616.60 | $630.96 | $954.99 |
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 $512.86 Median $870.96 Typical High $1,412.54 | Professional | None | $512.86 | $870.96 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $912.01 Median $1,288.25 Typical High $2,089.30 | Professional | 50 · Both sides | $912.01 | $1,288.25 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $380.19 Median $537.03 Typical High $891.25 | Professional | 62 · Two surgeons | $380.19 | $537.03 | $891.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $97.72 Median $138.04 Typical High $234.42 | Professional | 80 · Assistant surgeon | $97.72 | $138.04 | $234.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $85.11 Median $120.23 Typical High $194.98 | Professional | AS · PA/NP assist | $85.11 | $120.23 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,445.44 Typical High $1,995.26 | Facility | None | $602.56 | $1,445.44 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $977.24 Typical High $1,621.81 | Professional | None | $660.69 | $977.24 | $1,621.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $660.69 Median $741.31 Typical High $1,479.11 | Professional | None | $660.69 | $741.31 | $1,479.11 |
Oscar Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,096.48 | $1,096.48 | $1,096.48 |
United Setting Facility Modifier None Typical Low $501.19 Median $724.44 Typical High $3,548.13 | Facility | None | $501.19 | $724.44 | $3,548.13 |
United Setting Professional Modifier None Typical Low $512.86 Median $851.14 Typical High $1,584.89 | Professional | None | $512.86 | $851.14 | $1,584.89 |
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 $316.23 Median $316.23 Typical High $354.81 | Professional | 52 · Reduced service | $316.23 | $316.23 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $141.25 | Professional | 53 · Discontinued | $125.89 | $125.89 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $467.74 Typical High $524.81 | Professional | 54 · Surgery only | $467.74 | $467.74 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $95.50 Typical High $104.71 | Professional | 55 · Aftercare only | $93.33 | $95.50 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $70.79 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $436.52 | $436.52 | $489.78 |
Where Georgia sits
The same service costs 4.6 times more in Colorado than in Delaware. 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 $6,475DE $1,401
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.