How much rates vary
Facilitymedian $2,818 · 10th to 90th $776 to $8,710Professionalmedian $1,349 · 10th to 90th $871 to $2,291
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 $1,202.26 Median $5,370.32 Typical High $8,317.64 | Facility | None | $1,202.26 | $5,370.32 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,995.26 | Professional | None | $1,000.00 | $1,000.00 | $1,995.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $707.95 Median $1,584.89 Typical High $10,964.78 | Facility | None | $707.95 | $1,584.89 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $851.14 Median $1,348.96 Typical High $2,187.76 | Professional | None | $851.14 | $1,348.96 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,445.44 Median $2,089.30 Typical High $3,311.31 | Professional | 50 · Both sides | $1,445.44 | $2,089.30 | $3,311.31 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $616.60 Median $891.25 Typical High $1,412.54 | Professional | 62 · Two surgeons | $616.60 | $891.25 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $234.42 Typical High $371.54 | Professional | 80 · Assistant surgeon | $154.88 | $234.42 | $371.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $194.98 Typical High $316.23 | Professional | AS · PA/NP assist | $134.90 | $194.98 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $5,495.41 Typical High $6,918.31 | Facility | None | $741.31 | $5,495.41 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,548.82 Typical High $2,570.40 | Professional | None | $1,122.02 | $1,548.82 | $2,570.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,023.29 Median $1,148.15 Typical High $2,818.38 | Professional | None | $1,023.29 | $1,148.15 | $2,818.38 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $2,884.03 Typical High $8,709.64 | Facility | None | $1,258.93 | $2,884.03 | $8,709.64 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,445.44 Typical High $2,454.71 | Professional | None | $870.96 | $1,445.44 | $2,454.71 |
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 $501.19 Median $501.19 Typical High $562.34 | Professional | 52 · Reduced service | $501.19 | $501.19 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $223.87 | Professional | 53 · Discontinued | $199.53 | $199.53 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $758.58 Typical High $831.76 | Professional | 54 · Surgery only | $741.31 | $758.58 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $151.36 Typical High $165.96 | Professional | 55 · Aftercare only | $147.91 | $151.36 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $112.20 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $707.95 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $691.83 | $707.95 | $776.25 |
Where Georgia sits
The same service costs 4.7 times more in Colorado than in Hawaii. 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 $14,231HI $3,050
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.