How much rates vary
Facilitymedian $1,738 · 10th to 90th $525 to $12,882Professionalmedian $6,310 · 10th to 90th $3,981 to $9,333
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 $5,248.07 Median $5,370.32 Typical High $7,943.28 | Facility | None | $5,248.07 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $5,248.07 Median $5,248.07 Typical High $6,025.60 | Professional | None | $5,248.07 | $5,248.07 | $6,025.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $2,344.23 Typical High $16,218.10 | Facility | None | $1,288.25 | $2,344.23 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,981.07 Median $6,309.57 Typical High $8,511.38 | Professional | None | $3,981.07 | $6,309.57 | $8,511.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,884.03 Median $4,073.80 Typical High $5,370.32 | Professional | 62 · Two surgeons | $2,884.03 | $4,073.80 | $5,370.32 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $724.44 Median $1,023.29 Typical High $1,412.54 | Professional | 80 · Assistant surgeon | $724.44 | $1,023.29 | $1,412.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $645.65 Median $891.25 Typical High $1,202.26 | Professional | AS · PA/NP assist | $645.65 | $891.25 | $1,202.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4,677.35 Median $5,623.41 Typical High $7,079.46 | Professional | None | $4,677.35 | $5,623.41 | $7,079.46 |
United Setting Facility Modifier None Typical Low $371.54 Median $645.65 Typical High $3,981.07 | Facility | None | $371.54 | $645.65 | $3,981.07 |
United Setting Professional Modifier None Typical Low $3,981.07 Median $6,025.60 Typical High $13,803.84 | Professional | None | $3,981.07 | $6,025.60 | $13,803.84 |
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 $2,630.27 Median $2,630.27 Typical High $3,019.95 | Professional | 52 · Reduced service | $2,630.27 | $2,630.27 | $3,019.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,047.13 Median $1,047.13 Typical High $1,202.26 | Professional | 53 · Discontinued | $1,047.13 | $1,047.13 | $1,202.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,981.07 Median $3,981.07 Typical High $4,466.84 | Professional | 54 · Surgery only | $3,981.07 | $3,981.07 | $4,466.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $794.33 Median $794.33 Typical High $912.01 | Professional | 55 · Aftercare only | $794.33 | $794.33 | $912.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $524.81 Median $524.81 Typical High $602.56 | Professional | 56 · Pre-op care only | $524.81 | $524.81 | $602.56 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,715.35 Median $3,715.35 Typical High $4,168.69 | Professional | 78 · Unplanned return to OR | $3,715.35 | $3,715.35 | $4,168.69 |
Where Georgia sits
The same service costs 8.4 times more in Wisconsin than in Texas. 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 $28,671TX $3,407
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.