How much rates vary
Facilitymedian $2,042 · 10th to 90th $708 to $7,943Professionalmedian $912 · 10th to 90th $589 to $1,549
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 $660.69 Median $5,623.41 Typical High $18,197.01 | Facility | None | $660.69 | $5,623.41 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $1,778.28 | Professional | None | $660.69 | $660.69 | $1,778.28 |
Ambetter Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $676.08 Median $1,348.96 Typical High $8,128.31 | Facility | None | $676.08 | $1,348.96 | $8,128.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $588.84 Median $912.01 Typical High $1,479.11 | Professional | None | $588.84 | $912.01 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $977.24 Median $1,412.54 Typical High $2,238.72 | Professional | 50 · Both sides | $977.24 | $1,412.54 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $416.87 Median $602.56 Typical High $954.99 | Professional | 62 · Two surgeons | $416.87 | $602.56 | $954.99 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $154.88 Typical High $251.19 | Professional | 80 · Assistant surgeon | $104.71 | $154.88 | $251.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $128.82 Typical High $218.78 | Professional | AS · PA/NP assist | $91.20 | $128.82 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $6,025.60 Typical High $7,585.78 | Facility | None | $741.31 | $6,025.60 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $1,023.29 Typical High $1,698.24 | Professional | None | $741.31 | $1,023.29 | $1,698.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $691.83 Median $776.25 Typical High $1,949.84 | Professional | None | $691.83 | $776.25 | $1,949.84 |
Oscar Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | None | $1,174.90 | $1,174.90 | $1,174.90 |
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 $588.84 Median $954.99 Typical High $1,659.59 | Professional | None | $588.84 | $954.99 | $1,659.59 |
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 $331.13 Median $331.13 Typical High $371.54 | Professional | 52 · Reduced service | $331.13 | $331.13 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $147.91 | Professional | 53 · Discontinued | $131.83 | $131.83 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $501.19 Typical High $549.54 | Professional | 54 · Surgery only | $489.78 | $501.19 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $100.00 Typical High $112.20 | Professional | 55 · Aftercare only | $97.72 | $100.00 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $74.13 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $467.74 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $457.09 | $467.74 | $512.86 |
Where Georgia sits
The same service costs 5.4 times more in Alaska than in Montana. 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 $11,142MT $2,070
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.