How much rates vary
Facilitymedian $2,291 · 10th to 90th $832 to $8,511Professionalmedian $794 · 10th to 90th $661 to $1,202
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 $691.83 Median $851.14 Typical High $8,511.38 | Facility | None | $691.83 | $851.14 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $794.33 Typical High $891.25 | Professional | None | $691.83 | $794.33 | $891.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $3,311.31 Typical High $9,120.11 | Facility | None | $1,047.13 | $3,311.31 | $9,120.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $660.69 Median $776.25 Typical High $1,047.13 | Professional | None | $660.69 | $776.25 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $977.24 Median $1,148.15 Typical High $1,548.82 | Professional | 50 · Both sides | $977.24 | $1,148.15 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $416.87 Median $489.78 Typical High $660.69 | Professional | 62 · Two surgeons | $416.87 | $489.78 | $660.69 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $123.03 Typical High $165.96 | Professional | 80 · Assistant surgeon | $104.71 | $123.03 | $165.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $107.15 Typical High $144.54 | Professional | AS · PA/NP assist | $91.20 | $107.15 | $144.54 |
CareSource Setting Facility Modifier None Typical Low $630.96 Median $1,202.26 Typical High $2,691.53 | Facility | None | $630.96 | $1,202.26 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $741.31 Median $1,000.00 Typical High $1,230.27 | Professional | None | $741.31 | $1,000.00 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $1,905.46 Typical High $2,290.87 | Facility | None | $1,318.26 | $1,905.46 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $954.99 Typical High $4,677.35 | Professional | None | $758.58 | $954.99 | $4,677.35 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $371.54 | Professional | None | $33.11 | $33.11 | $371.54 |
United Setting Facility Modifier None Typical Low $741.31 Median $1,479.11 Typical High $5,128.61 | Facility | None | $741.31 | $1,479.11 | $5,128.61 |
United Setting Professional Modifier None Typical Low $741.31 Median $912.01 Typical High $1,412.54 | Professional | None | $741.31 | $912.01 | $1,412.54 |
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 $346.74 Median $389.05 Typical High $436.52 | Professional | 52 · Reduced service | $346.74 | $389.05 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $158.49 Typical High $177.83 | Professional | 53 · Discontinued | $138.04 | $158.49 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $588.84 Typical High $660.69 | Professional | 54 · Surgery only | $512.86 | $588.84 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $117.49 Typical High $131.83 | Professional | 55 · Aftercare only | $102.33 | $117.49 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $79.43 Typical High $89.13 | Professional | 56 · Pre-op care only | $69.18 | $79.43 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $549.54 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $478.63 | $549.54 | $616.60 |
Where Kentucky 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.