How much rates vary
Facilitymedian $1,905 · 10th to 90th $631 to $7,586Professionalmedian $891 · 10th to 90th $589 to $1,445
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 $1,348.96 Median $6,025.60 Typical High $13,803.84 | Facility | None | $1,348.96 | $6,025.60 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $630.96 Typical High $1,000.00 | Professional | None | $616.60 | $630.96 | $1,000.00 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | 50 · Both sides | $1,819.70 | $1,819.70 | $1,819.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $1,202.26 Typical High $7,585.78 | Facility | None | $575.44 | $1,202.26 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $588.84 Median $891.25 Typical High $1,412.54 | Professional | None | $588.84 | $891.25 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $933.25 Median $1,380.38 Typical High $2,089.30 | Professional | 50 · Both sides | $933.25 | $1,380.38 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $407.38 Median $575.44 Typical High $891.25 | Professional | 62 · Two surgeons | $407.38 | $575.44 | $891.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $95.50 Median $158.49 Typical High $229.09 | Professional | 80 · Assistant surgeon | $95.50 | $158.49 | $229.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $89.13 Median $128.82 Typical High $194.98 | Professional | AS · PA/NP assist | $89.13 | $128.82 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,949.84 Typical High $2,691.53 | Facility | None | $602.56 | $1,949.84 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $1,023.29 Typical High $1,548.82 | Professional | None | $741.31 | $1,023.29 | $1,548.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $602.56 Median $676.08 Typical High $1,995.26 | Professional | None | $602.56 | $676.08 | $1,995.26 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $7,585.78 | Facility | None | $954.99 | $1,995.26 | $7,585.78 |
United Setting Professional Modifier None Typical Low $575.44 Median $954.99 Typical High $1,584.89 | Professional | None | $575.44 | $954.99 | $1,584.89 |
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 $309.03 Median $309.03 Typical High $346.74 | Professional | 52 · Reduced service | $309.03 | $309.03 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $125.89 Typical High $138.04 | Professional | 53 · Discontinued | $123.03 | $125.89 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $467.74 Typical High $524.81 | Professional | 54 · Surgery only | $467.74 | $467.74 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $104.71 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $63.10 Typical High $69.18 | Professional | 56 · Pre-op care only | $61.66 | $63.10 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $436.52 | $436.52 | $489.78 |
Where Georgia sits
The same service costs 4.2 times more in Wisconsin 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
WI $7,788MT $1,867
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.