How much rates vary
Facilitymedian $3,236 · 10th to 90th $631 to $9,550Professionalmedian $1,230 · 10th to 90th $871 to $2,089
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 $912.01 Median $5,370.32 Typical High $7,943.28 | Facility | None | $912.01 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $954.99 Typical High $2,344.23 | Professional | None | $891.25 | $954.99 | $2,344.23 |
Ambetter Setting Professional Modifier None Typical Low $208.93 Median $1,513.56 Typical High $1,778.28 | Professional | None | $208.93 | $1,513.56 | $1,778.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,548.82 Typical High $10,964.78 | Facility | None | $588.84 | $1,548.82 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $870.96 Median $1,230.27 Typical High $1,995.26 | Professional | None | $870.96 | $1,230.27 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,318.26 Median $1,905.46 Typical High $3,019.95 | Professional | 50 · Both sides | $1,318.26 | $1,905.46 | $3,019.95 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $562.34 Median $794.33 Typical High $1,258.93 | Professional | 62 · Two surgeons | $562.34 | $794.33 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $213.80 Typical High $331.13 | Professional | 80 · Assistant surgeon | $141.25 | $213.80 | $331.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $177.83 Typical High $281.84 | Professional | AS · PA/NP assist | $123.03 | $177.83 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $5,248.07 Typical High $6,760.83 | Facility | None | $602.56 | $5,248.07 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,380.38 Typical High $2,290.87 | Professional | None | $977.24 | $1,380.38 | $2,290.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $933.25 Median $1,047.13 Typical High $2,398.83 | Professional | None | $933.25 | $1,047.13 | $2,398.83 |
Oscar Health Setting Professional Modifier None Typical Low $891.25 Median $1,513.56 Typical High $1,862.09 | Professional | None | $891.25 | $1,513.56 | $1,862.09 |
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 $794.33 Median $1,288.25 Typical High $2,238.72 | Professional | None | $794.33 | $1,288.25 | $2,238.72 |
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 $446.68 Median $457.09 Typical High $501.19 | Professional | 52 · Reduced service | $446.68 | $457.09 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $181.97 Typical High $199.53 | Professional | 53 · Discontinued | $177.83 | $181.97 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $676.08 Typical High $758.58 | Professional | 54 · Surgery only | $660.69 | $676.08 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $134.90 Typical High $151.36 | Professional | 55 · Aftercare only | $131.83 | $134.90 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $91.20 Typical High $100.00 | Professional | 56 · Pre-op care only | $89.13 | $91.20 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $630.96 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $616.60 | $630.96 | $707.95 |
Where Georgia sits
The same service costs 5.5 times more in Colorado than in Hawaii. 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
CO $14,085HI $2,567
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.