How much rates vary
Facilitymedian $2,692 · 10th to 90th $631 to $7,244Professionalmedian $2,291 · 10th to 90th $1,479 to $3,890
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 $1,698.24 Median $6,309.57 Typical High $10,000.00 | Facility | None | $1,698.24 | $6,309.57 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $2,691.53 | Professional | None | $1,698.24 | $1,698.24 | $2,691.53 |
Ambetter Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,479.11 | $1,479.11 | $1,479.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $1,148.15 Typical High $5,888.44 | Facility | None | $575.44 | $1,148.15 | $5,888.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,479.11 Median $2,290.87 Typical High $3,715.35 | Professional | None | $1,479.11 | $2,290.87 | $3,715.35 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,454.71 Median $3,548.13 Typical High $5,888.44 | Professional | 50 · Both sides | $2,454.71 | $3,548.13 | $5,888.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,047.13 Median $1,513.56 Typical High $2,454.71 | Professional | 62 · Two surgeons | $1,047.13 | $1,513.56 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $263.03 Median $407.38 Typical High $630.96 | Professional | 80 · Assistant surgeon | $263.03 | $407.38 | $630.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $229.09 Median $331.13 Typical High $549.54 | Professional | AS · PA/NP assist | $229.09 | $331.13 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $5,623.41 Typical High $7,079.46 | Facility | None | $630.96 | $5,623.41 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $1,905.46 Median $2,691.53 Typical High $4,365.16 | Professional | None | $1,905.46 | $2,691.53 | $4,365.16 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,698.24 Median $1,905.46 Typical High $3,388.44 | Professional | None | $1,698.24 | $1,905.46 | $3,388.44 |
Oscar Health Setting Professional Modifier None Typical Low $2,570.40 Median $2,818.38 Typical High $2,951.21 | Professional | None | $2,570.40 | $2,818.38 | $2,951.21 |
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 $1,513.56 Median $2,454.71 Typical High $4,466.84 | Professional | None | $1,513.56 | $2,454.71 | $4,466.84 |
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 $851.14 Median $851.14 Typical High $954.99 | Professional | 52 · Reduced service | $851.14 | $851.14 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $338.84 Typical High $380.19 | Professional | 53 · Discontinued | $338.84 | $338.84 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,258.93 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,258.93 | $1,258.93 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $257.04 Typical High $288.40 | Professional | 55 · Aftercare only | $257.04 | $257.04 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $169.82 Typical High $190.55 | Professional | 56 · Pre-op care only | $169.82 | $169.82 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,174.90 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,174.90 | $1,348.96 |
Where Georgia sits
The same service costs 4.7 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 $16,761KY $3,604
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.