How much rates vary
Facilitymedian $2,042 · 10th to 90th $692 to $7,413Professionalmedian $1,000 · 10th to 90th $589 to $1,660
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 $724.44 Median $5,370.32 Typical High $8,128.31 | Facility | None | $724.44 | $5,370.32 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $1,047.13 Typical High $1,862.09 | Professional | None | $602.56 | $1,047.13 | $1,862.09 |
Ambetter Setting Professional Modifier None Typical Low $707.95 Median $2,454.71 Typical High $2,454.71 | Professional | None | $707.95 | $2,454.71 | $2,454.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $616.60 Median $1,380.38 Typical High $7,413.10 | Facility | None | $616.60 | $1,380.38 | $7,413.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $575.44 Median $831.76 Typical High $1,479.11 | Professional | None | $575.44 | $831.76 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $977.24 Median $1,348.96 Typical High $2,290.87 | Professional | 50 · Both sides | $977.24 | $1,348.96 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $407.38 Median $562.34 Typical High $977.24 | Professional | 62 · Two surgeons | $407.38 | $562.34 | $977.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $95.50 Median $154.88 Typical High $251.19 | Professional | 80 · Assistant surgeon | $95.50 | $154.88 | $251.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $125.89 Typical High $218.78 | Professional | AS · PA/NP assist | $91.20 | $125.89 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $5,248.07 Typical High $6,760.83 | Facility | None | $812.83 | $5,248.07 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $1,174.90 Typical High $2,238.72 | Professional | None | $676.08 | $1,174.90 | $2,238.72 |
Kaiser Permanente Setting Professional Modifier None Typical Low $660.69 Median $1,202.26 Typical High $1,862.09 | Professional | None | $660.69 | $1,202.26 | $1,862.09 |
Oscar Health Setting Professional Modifier None Typical Low $645.65 Median $1,174.90 Typical High $2,137.96 | Professional | None | $645.65 | $1,174.90 | $2,137.96 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,041.74 Typical High $7,585.78 | Facility | None | $1,000.00 | $2,041.74 | $7,585.78 |
United Setting Professional Modifier None Typical Low $602.56 Median $1,148.15 Typical High $2,398.83 | Professional | None | $602.56 | $1,148.15 | $2,398.83 |
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 $302.00 Median $457.09 Typical High $549.54 | Professional | 52 · Reduced service | $302.00 | $457.09 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $181.97 Typical High $218.78 | Professional | 53 · Discontinued | $120.23 | $181.97 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $676.08 Typical High $831.76 | Professional | 54 · Surgery only | $446.68 | $676.08 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $134.90 Typical High $165.96 | Professional | 55 · Aftercare only | $89.13 | $134.90 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $91.20 Typical High $109.65 | Professional | 56 · Pre-op care only | $60.26 | $91.20 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $630.96 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $416.87 | $630.96 | $776.25 |
Where Georgia sits
The same service costs 5.1 times more in Alaska than in West Virginia. 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 $10,217WV $2,002
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.