How much rates vary
Facilitymedian $1,698 · 10th to 90th $550 to $7,079Professionalmedian $661 · 10th to 90th $468 to $1,259
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 $478.63 Median $4,897.79 Typical High $7,943.28 | Facility | None | $478.63 | $4,897.79 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $512.86 Typical High $1,288.25 | Professional | None | $478.63 | $512.86 | $1,288.25 |
Ambetter Setting Professional Modifier None Typical Low $281.84 Median $407.38 Typical High $870.96 | Professional | None | $281.84 | $407.38 | $870.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $512.86 Median $1,548.82 Typical High $10,964.78 | Facility | None | $512.86 | $1,548.82 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $467.74 Median $660.69 Typical High $1,202.26 | Professional | None | $467.74 | $660.69 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $309.03 Median $446.68 Typical High $794.33 | Professional | 62 · Two surgeons | $309.03 | $446.68 | $794.33 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $81.28 Median $125.89 Typical High $208.93 | Professional | 80 · Assistant surgeon | $81.28 | $125.89 | $208.93 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $67.61 Median $97.72 Typical High $173.78 | Professional | AS · PA/NP assist | $67.61 | $97.72 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $4,073.80 Typical High $5,128.61 | Facility | None | $524.81 | $4,073.80 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $794.33 Typical High $1,258.93 | Professional | None | $537.03 | $794.33 | $1,258.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $501.19 Median $562.34 Typical High $1,202.26 | Professional | None | $501.19 | $562.34 | $1,202.26 |
Oscar Health Setting Professional Modifier None Typical Low $478.63 Median $831.76 Typical High $1,023.29 | Professional | None | $478.63 | $831.76 | $1,023.29 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,513.56 Typical High $5,011.87 | Facility | None | $851.14 | $1,513.56 | $5,011.87 |
United Setting Professional Modifier None Typical Low $446.68 Median $741.31 Typical High $1,288.25 | Professional | None | $446.68 | $741.31 | $1,288.25 |
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 $239.88 Median $239.88 Typical High $269.15 | Professional | 52 · Reduced service | $239.88 | $239.88 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $97.72 Typical High $107.15 | Professional | 53 · Discontinued | $95.50 | $97.72 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $363.08 Typical High $407.38 | Professional | 54 · Surgery only | $363.08 | $363.08 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $81.28 | Professional | 55 · Aftercare only | $72.44 | $72.44 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $47.86 Typical High $53.70 | Professional | 56 · Pre-op care only | $47.86 | $47.86 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $338.84 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $338.84 | $338.84 | $380.19 |
Where Georgia sits
The same service costs 7.0 times more in Alabama 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
AL $10,808MT $1,535
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.