How much rates vary
Facilitymedian $1,862 · 10th to 90th $708 to $7,413Professionalmedian $1,148 · 10th to 90th $741 to $1,950
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 $5,623.41 Typical High $18,197.01 | Facility | None | $1,202.26 | $5,623.41 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $831.76 Typical High $1,288.25 | Professional | None | $812.83 | $831.76 | $1,288.25 |
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 $707.95 Median $1,148.15 Typical High $1,862.09 | Professional | None | $707.95 | $1,148.15 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,230.27 Median $1,698.24 Typical High $2,818.38 | Professional | 50 · Both sides | $1,230.27 | $1,698.24 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $512.86 Median $724.44 Typical High $1,174.90 | Professional | 62 · Two surgeons | $512.86 | $724.44 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $128.82 Median $194.98 Typical High $309.03 | Professional | 80 · Assistant surgeon | $128.82 | $194.98 | $309.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $158.49 Typical High $263.03 | Professional | AS · PA/NP assist | $114.82 | $158.49 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,905.46 Typical High $2,570.40 | Facility | None | $741.31 | $1,905.46 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,288.25 Typical High $2,137.96 | Professional | None | $933.25 | $1,288.25 | $2,137.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $851.14 Median $954.99 Typical High $1,621.81 | Professional | None | $851.14 | $954.99 | $1,621.81 |
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 $724.44 Median $1,202.26 Typical High $2,041.74 | Professional | None | $724.44 | $1,202.26 | $2,041.74 |
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 $416.87 Median $416.87 Typical High $467.74 | Professional | 52 · Reduced service | $416.87 | $416.87 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $186.21 | Professional | 53 · Discontinued | $165.96 | $165.96 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $630.96 Typical High $691.83 | Professional | 54 · Surgery only | $616.60 | $630.96 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $125.89 Typical High $138.04 | Professional | 55 · Aftercare only | $123.03 | $125.89 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $93.33 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $588.84 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $575.44 | $588.84 | $645.65 |
Where Georgia sits
The same service costs 3.1 times more in Wisconsin than in Maryland. 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
WI $8,115MD $2,591
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.