How much rates vary
Facilitymedian $1,995 · 10th to 90th $631 to $7,079Professionalmedian $1,202 · 10th to 90th $794 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 $870.96 Median $5,370.32 Typical High $7,943.28 | Facility | None | $870.96 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $977.24 | Professional | None | $870.96 | $870.96 | $977.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $1,148.15 Typical High $5,754.40 | Facility | None | $575.44 | $1,148.15 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $794.33 Median $1,202.26 Typical High $1,905.46 | Professional | None | $794.33 | $1,202.26 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,318.26 Median $1,862.09 Typical High $2,951.21 | Professional | 50 · Both sides | $1,318.26 | $1,862.09 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $549.54 Median $794.33 Typical High $1,230.27 | Professional | 62 · Two surgeons | $549.54 | $794.33 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $134.90 Median $218.78 Typical High $316.23 | Professional | 80 · Assistant surgeon | $134.90 | $218.78 | $316.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $173.78 Typical High $275.42 | Professional | AS · PA/NP assist | $123.03 | $173.78 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,995.26 Typical High $2,691.53 | Facility | None | $630.96 | $1,995.26 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,412.54 Typical High $2,187.76 | Professional | None | $1,000.00 | $1,412.54 | $2,187.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $870.96 Median $977.24 Typical High $2,187.76 | Professional | None | $870.96 | $977.24 | $2,187.76 |
Oscar Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,445.44 Typical High $1,479.11 | Professional | None | $1,288.25 | $1,445.44 | $1,479.11 |
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 $2,187.76 | Professional | None | $794.33 | $1,288.25 | $2,187.76 |
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 $436.52 Median $436.52 Typical High $489.78 | Professional | 52 · Reduced service | $436.52 | $436.52 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $199.53 | Professional | 53 · Discontinued | $173.78 | $173.78 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $741.31 | Professional | 54 · Surgery only | $660.69 | $660.69 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $147.91 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $97.72 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $691.83 |
Where Georgia sits
The same service costs 5.0 times more in Alabama 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
AL $11,256KY $2,261
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.