How much rates vary
Facilitymedian $2,884 · 10th to 90th $708 to $11,482Professionalmedian $1,514 · 10th to 90th $1,047 to $2,754
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 $1,096.48 Median $5,370.32 Typical High $10,000.00 | Facility | None | $1,096.48 | $5,370.32 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $2,951.21 | Professional | None | $1,096.48 | $1,096.48 | $2,951.21 |
Ambetter Setting Professional Modifier None Typical Low $1,995.26 Median $2,691.53 Typical High $2,691.53 | Professional | None | $1,995.26 | $2,691.53 | $2,691.53 |
Anthem BCBS Setting Facility Modifier None Typical Low $676.08 Median $1,348.96 Typical High $5,754.40 | Facility | None | $676.08 | $1,348.96 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,047.13 Median $1,513.56 Typical High $2,454.71 | Professional | None | $1,047.13 | $1,513.56 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,659.59 Median $2,344.23 Typical High $3,801.89 | Professional | 50 · Both sides | $1,659.59 | $2,344.23 | $3,801.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $707.95 Median $977.24 Typical High $1,584.89 | Professional | 62 · Two surgeons | $707.95 | $977.24 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $269.15 Typical High $407.38 | Professional | 80 · Assistant surgeon | $173.78 | $269.15 | $407.38 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $213.80 Typical High $354.81 | Professional | AS · PA/NP assist | $158.49 | $213.80 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $10,964.78 Typical High $14,454.40 | Facility | None | $602.56 | $10,964.78 | $14,454.40 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,737.80 Typical High $3,467.37 | Professional | None | $1,230.27 | $1,737.80 | $3,467.37 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,548.82 Median $1,737.80 Typical High $3,235.94 | Professional | None | $1,548.82 | $1,737.80 | $3,235.94 |
Oscar Health Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,905.46 | $1,905.46 | $1,905.46 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $3,715.35 Typical High $9,549.93 | Facility | None | $1,513.56 | $3,715.35 | $9,549.93 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,584.89 Typical High $3,162.28 | Professional | None | $1,000.00 | $1,584.89 | $3,162.28 |
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 $549.54 Median $549.54 Typical High $616.60 | Professional | 52 · Reduced service | $549.54 | $549.54 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $245.47 | Professional | 53 · Discontinued | $218.78 | $218.78 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $831.76 Typical High $933.25 | Professional | 54 · Surgery only | $831.76 | $831.76 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $186.21 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $123.03 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $776.25 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $776.25 | $776.25 | $870.96 |
Where Georgia sits
The same service costs 6.0 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 $15,585KY $2,601
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.