How much rates vary
Facilitymedian $3,090 · 10th to 90th $631 to $7,079Professionalmedian $2,884 · 10th to 90th $1,549 to $4,677
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 $2,089.30 Median $6,309.57 Typical High $10,000.00 | Facility | None | $2,089.30 | $6,309.57 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,570.40 | Professional | None | $2,089.30 | $2,089.30 | $2,570.40 |
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 $1,513.56 Median $2,884.03 Typical High $4,677.35 | Professional | None | $1,513.56 | $2,884.03 | $4,677.35 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,511.89 Median $4,265.80 Typical High $6,918.31 | Professional | 50 · Both sides | $2,511.89 | $4,265.80 | $6,918.31 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,071.52 Median $1,819.70 Typical High $2,884.03 | Professional | 62 · Two surgeons | $1,071.52 | $1,819.70 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $269.15 Median $457.09 Typical High $776.25 | Professional | 80 · Assistant surgeon | $269.15 | $457.09 | $776.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $234.42 Median $398.11 Typical High $645.65 | Professional | AS · PA/NP assist | $234.42 | $398.11 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $4,265.80 Typical High $5,370.32 | Facility | None | $630.96 | $4,265.80 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $3,235.94 Typical High $5,370.32 | Professional | None | $1,659.59 | $3,235.94 | $5,370.32 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,995.26 Median $2,344.23 Typical High $3,311.31 | Professional | None | $1,995.26 | $2,344.23 | $3,311.31 |
Oscar Health Setting Professional Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Professional | None | $3,630.78 | $3,630.78 | $3,630.78 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $3,715.35 Typical High $9,549.93 | Facility | None | $1,513.56 | $3,715.35 | $9,549.93 |
United Setting Professional Modifier None Typical Low $1,318.26 Median $2,570.40 Typical High $5,248.07 | Professional | None | $1,318.26 | $2,570.40 | $5,248.07 |
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 $1,047.13 Median $1,047.13 Typical High $1,202.26 | Professional | 52 · Reduced service | $1,047.13 | $1,047.13 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $426.58 Typical High $478.63 | Professional | 53 · Discontinued | $416.87 | $426.58 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,584.89 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,584.89 | $1,584.89 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $316.23 Typical High $354.81 | Professional | 55 · Aftercare only | $316.23 | $316.23 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $208.93 Typical High $239.88 | Professional | 56 · Pre-op care only | $208.93 | $208.93 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,479.11 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,479.11 | $1,659.59 |
Where Georgia sits
The same service costs 4.9 times more in Alaska than in Kentucky. 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
AK $18,090KY $3,723
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.