How much rates vary
Facilitymedian $1,585 · 10th to 90th $724 to $6,457Professionalmedian $1,479 · 10th to 90th $933 to $2,570
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 $1,174.90 Median $5,623.41 Typical High $10,000.00 | Facility | None | $1,174.90 | $5,623.41 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $2,754.23 | Professional | None | $1,174.90 | $1,174.90 | $2,754.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $691.83 Median $1,380.38 Typical High $7,244.36 | Facility | None | $691.83 | $1,380.38 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,479.11 Typical High $2,344.23 | Professional | None | $933.25 | $1,479.11 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $691.83 Median $954.99 Typical High $1,513.56 | Professional | 62 · Two surgeons | $691.83 | $954.99 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $263.03 Typical High $407.38 | Professional | 80 · Assistant surgeon | $173.78 | $263.03 | $407.38 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $213.80 Typical High $338.84 | Professional | AS · PA/NP assist | $151.36 | $213.80 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $3,388.44 Typical High $4,365.16 | Facility | None | $741.31 | $3,388.44 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,737.80 Typical High $2,818.38 | Professional | None | $1,174.90 | $1,737.80 | $2,818.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $933.25 Median $1,174.90 Typical High $3,548.13 | Professional | None | $933.25 | $1,174.90 | $3,548.13 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,479.11 Typical High $5,011.87 | Facility | None | $851.14 | $1,479.11 | $5,011.87 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,584.89 Typical High $3,090.30 | Professional | None | $1,096.48 | $1,584.89 | $3,090.30 |
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 $588.84 Median $588.84 Typical High $660.69 | Professional | 52 · Reduced service | $588.84 | $588.84 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $263.03 | Professional | 53 · Discontinued | $234.42 | $234.42 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $870.96 Typical High $1,000.00 | Professional | 54 · Surgery only | $870.96 | $870.96 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $173.78 Typical High $199.53 | Professional | 55 · Aftercare only | $173.78 | $173.78 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $131.83 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $812.83 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $812.83 | $812.83 | $933.25 |
Where Georgia sits
The same service costs 4.6 times more in Alaska 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
AK $11,283KY $2,440
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.