How much rates vary
Facilitymedian $3,311 · 10th to 90th $776 to $12,303Professionalmedian $1,096 · 10th to 90th $724 to $1,862
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 $794.33 Median $5,370.32 Typical High $8,317.64 | Facility | None | $794.33 | $5,370.32 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $851.14 Typical High $2,137.96 | Professional | None | $794.33 | $851.14 | $2,137.96 |
Ambetter Setting Professional Modifier None Typical Low $676.08 Median $912.01 Typical High $1,412.54 | Professional | None | $676.08 | $912.01 | $1,412.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $707.95 Median $1,659.59 Typical High $11,748.98 | Facility | None | $707.95 | $1,659.59 | $11,748.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $724.44 Median $1,096.48 Typical High $1,778.28 | Professional | None | $724.44 | $1,096.48 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,174.90 Median $1,737.80 Typical High $2,818.38 | Professional | 50 · Both sides | $1,174.90 | $1,737.80 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $501.19 Median $724.44 Typical High $1,174.90 | Professional | 62 · Two surgeons | $501.19 | $724.44 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $199.53 Typical High $295.12 | Professional | 80 · Assistant surgeon | $125.89 | $199.53 | $295.12 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $109.65 Median $158.49 Typical High $263.03 | Professional | AS · PA/NP assist | $109.65 | $158.49 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $10,232.93 Typical High $13,182.57 | Facility | None | $741.31 | $10,232.93 | $13,182.57 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,288.25 Typical High $2,041.74 | Professional | None | $891.25 | $1,288.25 | $2,041.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $812.83 Median $912.01 Typical High $2,089.30 | Professional | None | $812.83 | $912.01 | $2,089.30 |
Oscar Health Setting Professional Modifier None Typical Low $794.33 Median $1,348.96 Typical High $1,659.59 | Professional | None | $794.33 | $1,348.96 | $1,659.59 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $3,715.35 Typical High $10,000.00 | Facility | None | $1,513.56 | $3,715.35 | $10,000.00 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,202.26 Typical High $1,995.26 | Professional | None | $724.44 | $1,202.26 | $1,995.26 |
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 $398.11 Median $398.11 Typical High $446.68 | Professional | 52 · Reduced service | $398.11 | $398.11 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $177.83 | Professional | 53 · Discontinued | $158.49 | $158.49 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $676.08 | Professional | 54 · Surgery only | $602.56 | $602.56 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $134.90 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $89.13 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $630.96 |
Where Georgia sits
The same service costs 9.3 times more in Alaska 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
AK $23,115MT $2,489
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.